Severe cellulitis was defined as either death from the infection or a prolonged hospitalization.
Most bacterial isolates involved Staphylococcus aureus and/or Streptococcus species.
Parameters identified on multivariate analysis:
(1) age
(2) diabetes mellitus
(3) white blood cell count
(4) arteriosclerosis obliterans (peripheral vascular disease, with either claudication or past history of gangrene of a toe web, and with signs of chronic obstructive vascular disease on ultrasound or angiography)
|
Parameter
|
Finding
|
Points
|
|
age in years
|
< 70 years of age
|
0
|
|
|
>= 70 years of age
|
1
|
|
diabetes mellitus
|
absent
|
0
|
|
|
present
|
1
|
|
white blood cell count
|
< 13,600 per µL
|
0
|
|
|
>= 13,600 per µL
|
1
|
|
peripheral vascular disease
|
absent
|
0
|
|
|
present
|
1
|
where:
• The age range for nonsevere infections was 65 +/- 19 years and for severe was 76.6 +/- 15 years.
• The WBC count for nonsevere infections was 11,000 +/- 5,400 per µL and for severe infections was 13,600 +/- 7,100 per µL.
• Diabetes mellitus had the highest odds ratio (4.3). A higher number of points could be assigned rather than the 1 point used above.
total number of risk factors =
= SUM(points for all 4 risk factors)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 4
• The more risk factors present the greater the risk of severe cellulitis and complications.
Limitations:
• These would apply to the general medical populations. The presence of leukemia, immunosuppression or some other conditions would also increase the risk of severe infection.
