Skin and soft tissue infections in hospitalized and critically ill patients: a nationwide population-based study

BMC Infectious Diseases

Research Article

Hsiu-Nien Shen¹  Chin-Li Lu² 

[1] Department of Intensive Care Medicine, Chi Mei Medical Center, No. 901 Chung-Hwa Road, Yong-Kang City, Tainan, Taiwan;Department of Medical Research, Chi Mei Medical Center, No. 901 Chung-Hwa Road, Yong-Kang City, Tainan, Taiwan;

关键词: Intensive Care Unit;    Hospital Mortality;    Intensive Care Unit Admission;    Necrotizing Fasciitis;    Decubitus Ulcer;   

DOI  :  10.1186/1471-2334-10-151

 received in 2009-12-21, accepted in 2010-06-04,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundThe proportional distributions of various skin and soft tissue infections (SSTIs) with/without intensive care are unclear. Among SSTI patients, the prevalence and significance of complicating factors, such as comorbidities and infections other than skin/soft tissue (non-SST infections), remain poorly understood. We conducted this population-based study to characterize hospitalized SSTI patients with/without intensive care and to identify factors associated with patient outcome.MethodsWe analyzed first-episode SSTIs between January 1, 2005 and December 31, 2007 from the hospitalized claims data of a nationally representative sample of 1,000,000 people, about 5% of the population, enrolled in the Taiwan National Health Insurance program. We classified 18 groups of SSTIs into three major categories: 1) superficial; 2) deeper or healthcare-associated; and 3) gangrenous or necrotizing infections. Multivariate logistic regression models were applied to identify factors associated with intensive care unit (ICU) admission and hospital mortality.ResultsOf 146,686 patients ever hospitalized during the 3-year study period, we identified 11,390 (7.7%) patients having 12,030 SSTIs. Among these SSTI patients, 1,033 (9.1%) had ICU admission and 306 (2.7%) died at hospital discharge. The most common categories of SSTIs in ICU and non-ICU patients were "deeper or healthcare-associated" (62%) and "superficial" (60%) infections, respectively. Of all SSTI patients, 45.3% had comorbidities and 31.3% had non-SST infections. In the multivariate analyses adjusting for demographics and hospital levels, the presence of several comorbid conditions was associated with ICU admission or hospital mortality, but the results were inconsistent across most common SSTIs. In the same analyses, the presence of non-SST infections was consistently associated with increased risk of ICU admission (adjusted odds ratios [OR] 3.34, 95% confidence interval [CI] 2.91-3.83) and hospital mortality (adjusted OR 5.93, 95% CI 4.57-7.71).ConclusionsThe proportional distributions of various SSTIs differed between ICU and non-ICU patients. Nearly one-third of hospitalized SSTI patients had non-SST infections, and the presence of which predicted ICU admission and hospital mortality.

【 授权许可】

CC BY   
© Shen and Lu; licensee BioMed Central Ltd. 2010