Factors and clinical prediction score for complication development after cellulitis diagnosis in adult patients
Dublin Core
Title
Factors and clinical prediction score for complication development after cellulitis diagnosis in adult patients
Subject
Prediction score, Cellulitis, Sepsis, Bacteremia, Necrotizing fasciitis
Description
Abstract
Background Cellulitis is defined as a bacterial infection of the skin and subcutaneous tissue that can cause multiple
complications, such as sepsis and necrotizing fasciitis. In extreme cases, it may lead to multiorgan failure and death.
We sought to analyze the clinical factors that contribute to the development of complicated disease, including
demographics, clinical presentation, initial vital signs, and laboratory studies.
Methods Our study is a retrospective cohort study carried out in a university-based tertiary care hospital in Bangkok,
Thailand. Adult patients who presented with cellulitis from January 1, 2018, to December 31, 2022, were evaluated for
eligibility and inclusion in this study. All related variables for both outcomes, bacteremia and necrotizing fasciitis, were
gathered from electronic medical records and analyzed using multivariable logistic regression analysis.
Results Of the 1,560 visits to this hospital, 47 cases reported at least one complication, with bacteremia noted
in 27 visits (1.73%) and necrotizing fasciitis in 20 visits (1.27%). From the multivariable logistic regression analysis,
six variables emerge as predictors of cellulitis complications. These are: Age≥65 years, Body Mass Index≥30 kg/
m2
, diabetes mellitus, body temperature≥38 °C, systolic blood pressure≤100 mmHg, and involvement of lower
extremities. The predictive score was developed from these factors and was named the Ramathibodi Necrotizing
Fasciitis/Bacteremia (RAMA-NFB) Prediction Score. Our predictive score has an accuracy of 82.93% (95% CI, 0.77–0.89).
Patients in the high-risk group (RAMA NFB score>6) have a likelihood ratio of 8.75 (95% CI, 4.41–18.12; p<0.001) times
to develop complications of cellulitis.
Conclusion In our study, the RAMA-NFB Prediction Score predicts complications of necrotizing fasciitis and
bacteremia in adult patients who present with cellulitis. External validation of this predictive score is still needed for
further practical application.
Background Cellulitis is defined as a bacterial infection of the skin and subcutaneous tissue that can cause multiple
complications, such as sepsis and necrotizing fasciitis. In extreme cases, it may lead to multiorgan failure and death.
We sought to analyze the clinical factors that contribute to the development of complicated disease, including
demographics, clinical presentation, initial vital signs, and laboratory studies.
Methods Our study is a retrospective cohort study carried out in a university-based tertiary care hospital in Bangkok,
Thailand. Adult patients who presented with cellulitis from January 1, 2018, to December 31, 2022, were evaluated for
eligibility and inclusion in this study. All related variables for both outcomes, bacteremia and necrotizing fasciitis, were
gathered from electronic medical records and analyzed using multivariable logistic regression analysis.
Results Of the 1,560 visits to this hospital, 47 cases reported at least one complication, with bacteremia noted
in 27 visits (1.73%) and necrotizing fasciitis in 20 visits (1.27%). From the multivariable logistic regression analysis,
six variables emerge as predictors of cellulitis complications. These are: Age≥65 years, Body Mass Index≥30 kg/
m2
, diabetes mellitus, body temperature≥38 °C, systolic blood pressure≤100 mmHg, and involvement of lower
extremities. The predictive score was developed from these factors and was named the Ramathibodi Necrotizing
Fasciitis/Bacteremia (RAMA-NFB) Prediction Score. Our predictive score has an accuracy of 82.93% (95% CI, 0.77–0.89).
Patients in the high-risk group (RAMA NFB score>6) have a likelihood ratio of 8.75 (95% CI, 4.41–18.12; p<0.001) times
to develop complications of cellulitis.
Conclusion In our study, the RAMA-NFB Prediction Score predicts complications of necrotizing fasciitis and
bacteremia in adult patients who present with cellulitis. External validation of this predictive score is still needed for
further practical application.
Creator
Welawat Tienpratarn1
, Chaiyaporn Yuksen1
, Joseph Daniel Pauly2*, Diana Vu3
, Anisa Noiwong Benbourenane3
and
Nuttamon Sangskul1
, Chaiyaporn Yuksen1
, Joseph Daniel Pauly2*, Diana Vu3
, Anisa Noiwong Benbourenane3
and
Nuttamon Sangskul1
Source
https://doi.org/10.1186/s12245-024-00646-w
Date
2024
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Welawat Tienpratarn1
, Chaiyaporn Yuksen1
, Joseph Daniel Pauly2*, Diana Vu3
, Anisa Noiwong Benbourenane3
and
Nuttamon Sangskul1, “Factors and clinical prediction score for complication development after cellulitis diagnosis in adult patients,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12352.