Predictors for readmission due to cellulitis among Japanese patients

Abstract

Cellulitis is a skin and soft tissue infection that is accompanied by symptoms, such as swelling, flushing, and pain [1]. The main causative bacterial species are group A β-Streptococcus and Staphylococcus aureus [2]. Some patients, especially those with chronic swelling (lymphedema), obesity, and diabetes, are at an increased risk of cellulitis [1,3]. Previous studies have reported that 41% to 45.3% of cellulitis cases eventually recur [4].A recurrence prediction score for the cellulitis of the lower limbs has been developed, and patients with lymphedema, chronic venous insufficiency, peripheral circulatory disturbance, and deep vein thrombosis are considered to be at risk [4]. While this score is expected to be applied clinically, it has limited usefulness because it

Malnutrition, hypertension, and hyperlipidemia as risk factors for recurrent cellulitis

“…In contrast it is unclear why hyperlipidemia is associated with the recurrence of cellulitis in the Japanese population 4 . Oxidized LDL (ox-LDL) is known to activate dendritic cells (DCs) in hyperlipidemia 7 .…”

“… 3 In addition, LVA, as a treatment of lymphedema, might also prevent the recurrence of cellulitis. In contrast, Norimatsu and Ohno 4 reported that hyperlipidemia, hypertension, hypoalbuminemia, and lymphedema are significant risk factors for recurrent cellulitis in the Japanese population. Hypoalbuminemia, in particular, is a risk factor in the Japanese population.…”

“…Moreover, the body mass index of Japanese patients with cellulitis will not be as high as that of patients in other countries, suggesting that poor nutrition might be involved in the recurrence of cellulitis. 4 Yoshida et al 1 did not report the serum albumin levels or body mass index; therefore, their patient's nutritional status is unclear. Patients with dementia and those with cancer are known to have a greater risk of malnutrition.…”

“…Hypertension is also a risk factor for the recurrence of cellulitis, independently of the presence of lymphedema. 4 In contrast, it is unclear why hyperlipidemia has been associated with the recurrence of cellulitis in the Japanese population. 4 Oxidized low-density lipoprotein is known to activate dendritic cells (DCs) in the presence of hyperlipidemia.…”

Characteristics of Japanese Patients With Disseminated Herpes Zoster: A Retrospective Study of 20 Cases

“…However, the risk factors for recurrent cellulitis are reportedly different from those in other countries due to the different characteristics of Japanese patients [9].…”