Cellulitis in older people over 75 years – are there differences?

Abstract

AimTo examine differences in risk factors, clinical features and outcomes of cellulitis between those 75 + years and those <75 years admitted to a metropolitan hospital.MethodsA prospective study of patients with limb cellulitis requiring intravenous antibiotics conducted at Bankstown-Lidcombe Hospital, Australia from June 2014 to April 2015.ResultsThirty one patients were 75 + years and 69 less than 75 years. A greater proportion of older patients resided in nursing home (25.8% vs 2.9% respectively, p = 0.001) and mobilized with walking aid(s) (58.1% vs 11.6% respectively, p < 0.001). Significantly more older patients had documented hypertension (45.2% vs 23.2% respectively p = 0.035), atrial fibrillation (33.5% vs 5.8% respectively, p < 0.001), dementia (22.6% vs 1.4% respectively, p = 0.001) and malignancy (16.1% vs 1.4% respectively, p = 0.010). The clinical presentation of cellulitis and cellulitis severity (Eron classification) did not significantly differ in both groups; however older patients were more likely to have dependent edema (OR 4.0, 95%CI 1.3–12.6, p = 0.018) and less likely to be obese (OR 0.3, 95%CI 0.1–0.8, p = 0.012) or had a past history of cellulitis (OR 0.3, 95%CI 0.1–1.0, p = 0.044) on presentation. Despite the age difference, there were no major differences in intravenous antibiotic choice, hospital length of stay, and hospital readmission rates in both groups. Older patients however, were more likely to experience complications such as falls and/or decreased mobility (38.7% vs 15.9% respectively, p = 0.020) during the cellulitis episode.ConclusionThere are minor differences in the risk factors and clinical features of cellulitis in older patients as compared to the young. Outcomes are similar except for a higher incidence of hospital related complications.

Predictors for readmission due to cellulitis among Japanese patients

“…In contrast, our study showed no significant difference between the two groups in terms of chronic venous insufficiency, peripheral circulatory disturbance, and deep vein thrombosis. Lymphedema has been suggested to be significantly more prevalent in patients aged 75 years or more, but chronic venous insufficiency, peripheral circulatory disturbance, and deep vein thrombosis have not been suggested to differ significantly with 2 , respectively, with a significant difference at P < 0.001 [10]. In this study, there was no significant difference of approximately 25 in both single and multiple hospitalization cases.…”

Risk Factors Associated with Occurrence of Cellulitis in Critically Ill Patients with Fulminant Hepatic Failure

“…Hepatotoxicity is primarily caused by the build-up of toxic metabolites, which are also responsible for immunological processes and toxic metabolites (Dong et al, 2020). Kumar et al (2020) stated that after hospitalization, age is considered as an independent risk factor for increased length of stay for cellulitis, alongside with some other factors including duration of symptoms, tachycardia, hypotension, increased white blood count, decreased albumin, increased serum creatinine, presence of bacteraemia, increased body mass index, and hyperglycaemia. Njim et al (2017) divided the risk factors for cellulitis into global and regional components.…”