title: Incidence and factors associated with emergency department visits for recurrent skin and soft tissue infections in patients in California, 2005-2011.
abstract: More than 2 million visits for skin and soft tissue infections (SSTIs) are seen in US emergency departments (EDs) yearly. Up to 50% of patients with SSTIs, suffer from recurrences, but associated factors remain poorly understood. We performed a retrospective study of patients with primary diagnosis of SSTI between 2005 and 2011 using California ED discharge data from the State Emergency Department Databases and State Inpatient Databases. Using a multivariable logistic regression, we examined factors associated with a repeat SSTI ED visits up to 6 months after the initial SSTI. Among 197 371 SSTIs, 16·3% were associated with a recurrent ED visit. We found no trend in recurrent visits over time (χ 2 trend = 0·68, P = 0·4). Race/ethnicity, age, geographical location, household income, and comorbidities were all associated with recurrent visits. Recurrent ED visits were associated with drug/alcohol abuse or liver disease [odds ratio (OR) 1·4, 95% confidence interval (CI) 1·3-1·4], obesity (OR 1·3, 95% CI 1·2-1·4), and in infections that were drained (OR 1·1, 95% CI 1·1-1·1) and inversely associated with hospitalization after initial ED visit (OR 0·4, 95% CI 0·3-0·4). In conclusion, we found several patient-level factors associated with recurrent ED visits. Identification of these high-risk groups is critical for future ED-based interventions.
authors.affiliation: University of California-Davis,Department of Emergency Medicine,Sacramento, CA,USA.
authors.forename: L
authors.initials: L
authors.lastname: May
authors.affiliation: Johns Hopkins University,Department of Emergency Medicine,Baltimore, MD,USA.
authors.forename: E Y
authors.initials: EY
authors.lastname: Klein
authors.affiliation: Center for Disease Dynamics,Economics & Policy, Washington,DC,USA.
authors.forename: E M
authors.initials: EM
authors.lastname: Martinez
authors.affiliation: Center for Disease Dynamics,Economics & Policy, Washington,DC,USA.
authors.forename: N
authors.initials: N
authors.lastname: Mojica
authors.affiliation: Division of Infectious Diseases,Harbor-University of California, Los Angeles (UCLA) Medical Center, and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center,Torrance, CA,USA.
authors.forename: L G
authors.initials: LG
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012874:Skin Diseases, Infectious / Q000175:diagnosis* / Q000453:epidemiology*; D018461:Soft Tissue Infections / Q000175:diagnosis* / Q000453:epidemiology*; D055815:Young Adult
keywords: Skin and soft tissue