Association of the Dundee severity classification with mortality, length of stay and readmission in adult inpatients with cellulitis.

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dc.contributor.author Cutfield, Tim en
dc.contributor.author Walter, Hannah en
dc.contributor.author Hobbs, Mark en
dc.contributor.author Chuang, Ariel en
dc.contributor.author Thomas, Mark en
dc.contributor.author Ritchie, Stephen en
dc.date.accessioned 2019-06-19T21:00:15Z en
dc.date.issued 2019-01 en
dc.identifier.issn 0305-7453 en
dc.identifier.uri http://hdl.handle.net/2292/47219 en
dc.description.abstract Background:The Dundee classification is a simple severity assessment tool that could optimize treatment decisions and clinical outcomes in adult patients with cellulitis; however, it has not been validated in a large cohort. Objectives:To determine whether the Dundee classification reliably identified those patients with cellulitis who had a higher mortality, a longer length of hospital stay or an increased risk of readmission. Methods:We performed a retrospective study of all adults with a primary discharge diagnosis of cellulitis admitted to Auckland City Hospital from August 2013 to June 2015. We classified patients by severity using the Dundee scoring system. Results:The 30 day all-cause mortality in adult patients with a discharge diagnosis of cellulitis was 2% (29/1462) overall, and was 1% (10/806), 2% (6/271), 3% (10/353) and 9% (3/32) in Classes 1, 2, 3 and 4 of the Dundee classification, respectively (P = 0.01). Mortality was strongly associated with age >65 years (OR 9.37, 95% CI 3.00-41.23) and with heart failure (OR 6.16, 95% CI 2.73-14.23). There were significant associations between the Dundee classification and the incidence of bacteraemia, the length of hospital stay and the rate of readmission to hospital. Conclusions:The Dundee classification is a simple, reliable tool that can be easily applied in clinical settings to predict risk of mortality in order to determine which patients can be managed in the community with oral or intravenous therapy, and which require inpatient care. en
dc.format.medium Print en
dc.language eng en
dc.relation.ispartofseries The Journal of antimicrobial chemotherapy en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.subject Humans en
dc.subject Cellulitis en
dc.subject Prognosis en
dc.subject Length of Stay en
dc.subject Patient Readmission en
dc.subject Severity of Illness Index en
dc.subject Risk Assessment en
dc.subject Survival Analysis en
dc.subject Retrospective Studies en
dc.subject Adolescent en
dc.subject Adult en
dc.subject Aged en
dc.subject Aged, 80 and over en
dc.subject Middle Aged en
dc.subject New Zealand en
dc.subject Female en
dc.subject Male en
dc.subject Young Adult en
dc.subject Clinical Decision Rules en
dc.title Association of the Dundee severity classification with mortality, length of stay and readmission in adult inpatients with cellulitis. en
dc.type Journal Article en
dc.identifier.doi 10.1093/jac/dky400 en
pubs.issue 1 en
pubs.begin-page 200 en
pubs.volume 74 en
dc.rights.holder Copyright: The author en
pubs.end-page 206 en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Research Support, Non-U.S. Gov't en
pubs.subtype Journal Article en
pubs.elements-id 759530 en
pubs.org-id Medical and Health Sciences en
pubs.org-id Medical Sciences en
pubs.org-id Molecular Medicine en
dc.identifier.eissn 1460-2091 en
pubs.record-created-at-source-date 2018-10-09 en
pubs.dimensions-id 30295790 en


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