title: Which patients with dermatological conditions are admitted via the emergency department?
abstract: OBJECTIVE
  Most dermatology admissions to tertiary hospitals in Australia are initially assessed in the emergency department (ED). This 3-year retrospective study examined the types of dermatological conditions that necessitated admission, the factors that predicted admission and the implications for dermatological resource allocation.
  
  
  METHODS
  The ED database was searched using the International Statistical Classification of Diseases, 10(th) revision (ICD-10) diagnosis codes and keywords in the presenting complaint and triage notes fields. The two lists were then merged and duplicates removed. All admissions were analysed and the medical records of admissions to the dermatology unit were reviewed to determine their final diagnosis.
  
  
  RESULTS
  In total, 4817 patients with dermatological conditions presented over the 3-year period. Of these, 937 (20%) required admission, of whom 108 (12%) were admitted under the dermatology unit. The most common conditions requiring admission were cellulitis (n = 534, 56%), boils, furuncles and pilonidal sinuses (n = 183, 19%), and non-specific skin infections (n = 32, 3%). The most common conditions admitted under dermatology were psoriasis (n = 27, 25%), eczema (n = 25, 23%), and cellulitis (n = 16, 15%). Key predictors of admission were Australasian triage code, referral by a health-care professional or corrections officer and arrival by ambulance.
  
  
  CONCLUSIONS
  Approximately one-fifth of dermatological presentations required admission, mostly for infective processes that did not require specific dermatological care. The predictors of admission reflect the severity of the condition and patients demonstrating these predictors should be referred to the Dermatology unit for admission.
authors.affiliation: Department of Medicine (Dermatology), St Vincent's Hospital Melbourne, Melbourne, Australia.
authors.forename: Julia E
authors.initials: JE
authors.lastname: Lai-Kwon
authors.forename: Tracey J
authors.initials: TJ
authors.lastname: Weiland
authors.forename: George A
authors.initials: GA
authors.lastname: Jelinek
authors.forename: Alvin H
authors.initials: AH
authors.lastname: Chong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002481:Cellulitis / Q000453:epidemiology; D004485:Eczema / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005076:Exanthema / Q000453:epidemiology; D005260:Female; D005667:Furunculosis / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007169:Impetigo / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010864:Pilonidal Sinus / Q000453:epidemiology; D011565:Psoriasis / Q000453:epidemiology; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012871:Skin Diseases / Q000175:diagnosis* / Q000453:epidemiology; D014218:Triage; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult
keywords: emergency service; epidemiology; hospital; retrospective; skin disease