Background
Methods
Database
Study Sample
Patient selection and definition
Measurements
Statistics
Results
Demographics and clinical characteristics
Variables | No | % |
---|---|---|
Variables
| 11,390 | 100 |
Age, yr
| 58 (39-74)* | |
<18
| 872 | 7.7 |
18-64
| 5,824 | 51.1 |
≥65
| 4,694 | 41.2 |
Men
| 6,924 | 60.8 |
Women
| 4,466 | 39.2 |
Medical conditions
| 8,230 | 72.3 |
Surgical conditions
| 3,160 | 27.7 |
Hospital level
| ||
Medical center
| 3,293 | 28.9 |
Regional hospital
| 4,786 | 42.0 |
District hospital
| 3,310 | 29.1 |
Charlson Comorbidity Index
| 0 (0-1)* | |
0
| 6,235 | 54.7 |
1
| 2,552 | 22.4 |
2
| 1,498 | 13.2 |
≥3
| 1,105 | 9.7 |
Comorbid conditions
| ||
Chronic obstructive pulmonary disease
| 535 | 4.7 |
Congestive heart failure
| 355 | 3.1 |
Cerebrovascular disease
| 666 | 5.8 |
Diabetes mellitus
| 2,507 | 22.0 |
End stage renal disease
| 567 | 5.0 |
Cirrhosis
| 285 | 2.5 |
Cancer
| 788 | 6.9 |
Infections other than skin/soft tissue
#
| 3,570 | 31.3 |
Respiratory
| 1,009 | 8.9 |
Intra-abdominal
| 884 | 7.8 |
Genitourinary tract
| 839 | 7.4 |
Others
| 1,494 | 13.1 |
Variables | n | % |
---|---|---|
Superficial infections | 6,840 | 56.9 |
Acute lymphadenitis | 136 | 1.1 |
Carbuncle/funruncle | 224 | 1.9 |
Cellulitis/abscess of finger/toe | 368 | 3.1 |
Impetigo | 28 | 0.2 |
Amputation stump infection | 28 | 0.2 |
Other cellulitis/abscess | 5,982 | 49.7 |
Other local soft tissue infection | 252 | 2.1 |
Deeper or healthcare-associated infections
|
4,317
|
35.9
|
Anal/rectal abscess | 626 | 5.2 |
Chronic ulcer of specified/unspecified sites | 57 | 0.5 |
Decubitus ulcer | 1,324 | 11.0 |
Infection due to vascular device/implant | 377 | 3.1 |
Pilonidal cyst with abscess | 17 | 0.1 |
Post-operation wound infection | 1,262 | 10.5 |
Post-traumatic wound infection | 212 | 1.8 |
Lower limb ulcer except decubitus | 498 | 4.1 |
Gangrenous or necrotizing Infections
|
873
|
7.3
|
Gangrene | 506 | 4.2 |
Necrotizing fasciitis | 357 | 3.0 |
Fournier's gangrene | 42 | 0.3 |
Total
|
12,030
|
100.0
|
Variables | Other cellulitis or abscess | Decubitus ulcer | Post-operation wound infection | Infection due to vascular device/implant | Gangrene | Necrotizing fasciitis |
---|---|---|---|---|---|---|
ICU (n = 227)/Non-ICU (n = 5,755) | ICU (n = 302)/Non-ICU (n = 1,022) | ICU (n = 225)/Non-ICU (n = 1,037) | ICU (n = 80)/Non-ICU (n = 297) | ICU (n = 78)/Non-ICU (n = 428) | ICU (n = 85)/Non-ICU (n = 272) | |
Age ≥65 yr
| 55.9/35.3* | 83.1/81.8 | 52.0/31.6* | 61.3/49.5 | 75.6/58.9#
| 45.9/32.4#
|
Men
| 63.0/60.7 | 57.3/52.2 | 66.7/61.6 | 48.8/51.2 | 61.5/53.5 | 69.4/66.2 |
Surgical conditions
| 37.0/10.2* | 24.8/14.5* | 92.9/51.3* | 67.5/56.2 | 65.4/59.8 | 77.6/72.4 |
Hospital levels, Center/Regional/District
| 34.4, 45.4, 20.3/25.4, 42.5, 32.1* | 17.2, 46.7, 36.1/20.5, 33.6, 45.9* | 45.8, 44.0, 10.2/41.5, 39.7, 18.8#
| 36.3,53.8, 10.0/51.5, 42.8, 5.7 | 35.9, 44.9, 19.2/29.7, 39.7, 30.6 | 43.5, 47.1, 9.4/18.4, 62.1, 19.5* |
Charlson Comorbid Index ≥1
| 70.0/37.1* | 60.9/69.4#
| 63.6/37.8* | 85.0/97.0* | 73.1/71.5 | 67.1/52.9#
|
Comorbid conditions
| ||||||
COPD
| 6.6/4.0 | 14.2/12.3 | 4.0/2.0 | 2.5/3.4 | 3.8/3.3 | 1.2/2.6 |
Congestive heart failure
| 11.9/2.6* | 8.6/5.5#
| 3.1/0.6#
| 12.5/3.4#
| 12.8/3.7#
| 5.9/2.9 |
Cerebrovascular disease
| 11.5/3.8* | 16.6/21.8#
| 7.6/2.1* | 8.8/3.0#
| 10.3/7.0 | 2.4/4.0 |
Diabetes mellitus
| 32.6/21.2* | 21.2/25.8 | 15.6/16.4 | 16.3/21.2 | 23.1/23.6 | 44.7/33.8 |
End stage renal disease
| 7.0/2.8* | 6.6/4.1 | 2.7/2.2 | 47.5/52.2 | 17.9/9.1#
| 5.9/2.9 |
Cirrhosis
| 8.8/2.8* | 1.3/1.9 | 1.8/1.7 | 1.3/2.4 | 5.1/0.2* | 11.8/2.9#
|
Cancer
| 9.3/4.1* | 5.6/7.2 | 29.3/15.6* | 18.8/38.0#
| 2.6/2.6 | 9.4/1.5* |
Infections other than SST
| 51.1/18.0* | 78.5/56.6* | 44.9/21.2* | 62.5/38.4* | 50.0/17.8* | 56.5/22.8* |
Hospital mortality, %
| 14.5/0.6* | 20.2/6.2* | 8.9/0.5* | 17.5/3.4* | 23.1/2.8* | 28.2/1.5* |
Factors associated with ICU admission and hospital mortality for SSTIs
Variables | Other cellulitis or abscess | Decubitus ulcer | Post-operation wound infection | Infection due to vascular device/implant | Gangrene | Necrotizing fasciitis |
---|---|---|---|---|---|---|
Age ≥65 yr
| 1.88(1.40-2.52) | 2.43(1.75-3.39) | ||||
Surgical conditions
| 5.49(4.04-7.45) | 2.46(1.75-3.46) | 13.38(7.73-23.17) | 2.54(1.40-4.62) | ||
Hospital level
| ||||||
Medical center
| 1 | 1 | 1 | |||
Regional hospital
| 0.90(0.65-1.24) | 1.54(1.06-2.24) | 0.38(0.21-0.69) | |||
District hospital
| 0.56(0.38-0.83) | 0.95(0.65-1.40) | 0.25(0.10-0.61) | |||
Comorbid conditions
| ||||||
Congestive heart failure
| 5.01(3.09-8.11) | 1.89(1.13-3.19) | 4.07(1.03-16.18) | 4.07(1.50-11.06) | 4.33(1.78-10.56) | |
Cerebrovascular disease
| 3.25(2.01-5.27) | 4.67(2.10-10.36) | ||||
End stage renal disease
| 0.27(0.14-0.53) | |||||
Cirrhosis
| 3.42(2.00-5.85) | 35.81(3.77-340.61) | 4.28(1.46-12.51) | |||
Cancer
| 1.95(1.17-3.25) | 2.61(1.78-3.82) | 0.17(0.08-0.38) | 5.35(1.42-20.16) | ||
Infections other than SST
| 4.51(3.40-5.99) | 3.27(2.39-4.49) | 2.86(2.04-4.02) | 2.61(1.52-4.50) | 5.01(2.96-8.49) | 4.02(2.33-6.95) |
P-value for goodness-of-fit
| 0.081 | 0.970 | 0.375 | 0.846 | 0.374 | 0.542 |
Nagelkerke pseudo-R
2
| 0.202 | 0.107 | 0.314 | 0.200 | 0.179 | 0.242 |
Variables | Other cellulitis or abscess | Decubitus ulcer | Post-operation wound infection | Infection due to vascular device/implant | Gangrene | Necrotizing fasciitis |
---|---|---|---|---|---|---|
Age ≥65 yr
| 2.83(1.66-4.83) | 4.02(1.62-9.96) | 4.35(1.27-14.87) | |||
Surgical conditions
| 2.14(1.16-3.94) | 0.46(0.24-0.84) | ||||
Comorbid conditions
| ||||||
Congestive heart failure
| 9.66(1.72-54.20) | |||||
Cerebrovascular disease
| 0.45(0.24-0.84) | |||||
End stage renal disease
| 3.05(1.28-7.26) | |||||
Cirrhosis
| 2.55(1.06-6.12) | 7.84(1.17-52.31) | 8.75(2.56-29.80) | |||
Cancer
| 10.44(5.83-18.68) | 3.99(2.35-6.75) | 5.65(2.39-13.35) | 4.39(1.04-18.40) | 24.74(6.09-100.39) | |
Infections other than SST
| 8.43(4.95-14.36) | 1.56(1.02-2.38) | 9.04(3.61-22.62) | 11.04(3.16-38.50) | 4.27(1.96-9.29) | 7.28(2.80-18.92) |
P-value for goodness-of-fit
| 0.265 | 0.854 | 0.045 | 0.452 | 0.358 | 0.667 |
Nagelkerke pseudo-R
2
| 0.229 | 0.072 | 0.242 | 0.172 | 0.156 | 0.319 |