Conference Coverage

Cellulitis ranks as top reason for skin-related pediatric inpatient admissions


 

REPORTING FROM SPD 2019

The majority of skin-related pediatric inpatient admissions in the United States involve treatment for cellulitis, results from a large study of national data showed.

Fourth-year medical student, Rutgers New Jersey Medical School–Newark

Marcus L. Elias

“Skin conditions significantly affect pediatric inpatients, and dermatologists ought be accessible for consultation to enhance care and costs,” the study’s first author, Marcus L. Elias, said in an interview prior to the annual meeting of the Society for Pediatric Dermatology.

According to Mr. Elias, who is a 4th-year medical student at Rutgers New Jersey Medical School–Newark, few national studies on skin diseases for pediatric inpatients have been published in the medical literature. Earlier this year, researchers examined inpatient dermatologic conditions in patients aged 18 years and older (J Am Acad Dermatol 2019;80[2]:425-32), but Mr. Elias and associates set out to analyze the burden of inpatient pediatric dermatologic conditions on a national basis. “We wanted to see if the same conditions that were hospitalizing adults were also hospitalizing kids,” he said. “We found that this was indeed the case.”

The researchers queried the National Inpatient Sample database for all cases involving patients aged 18 years and younger during 2001-2013. The search yielded a sample of 16,837,857 patients. From this, the researchers analyzed diagnosis-related groups for dermatologic conditions denoting the principal diagnosis at discharge, which left a final sample of 84,090 patients. Frequency and chi-squared tests were used to analyze categorical variables.

More than half of patients (54%) were male, 36% were white, 48% had Medicaid insurance, and 43% had private insurance. Mr. Elias reported that the median length of stay for patients was 2 days and the median cost of care was $6,289.50 for each case. More than three-quarters of pediatric inpatients with dermatologic diagnoses were treated for “cellulitis” (66,147 cases, or 79%), with most cases involving the legs (16,875 cases, or 20%). Other pediatric inpatients were admitted for “minor skin disorder without complications” (5,458 cases, or 7%), and “minor skin disorder with complications” (2,822 cases, or 3%). A total of 64 patients died during the study period. Of these, 31 cases (50%) involved “skin graft and/or debridement of skin ulcer or cellulitis without complications,” the study found.

“We were surprised that the major cause of mortality for our patients was classified as ‘skin graft and/or debridement of skin ulcer or cellulitis without complications,’ as a similar diagnosis-related groupings exist denoting that complications did arise,” Mr. Elias said. “Still, it is not possible for us to determine if the mortality was from the skin graft/debridement or another cause entirely. It is possible that the procedure was without complications, only to have the patient succumb to an ancillary process.”

He acknowledged certain limitations of the study, including the fact that the function of dermatologic consults for hospitalized patients was not examined. “We also cannot draw conclusions as to whether improved outpatient therapy reduces the need for hospitalization,” he said. Mr. Elias reported having no financial disclosures.

Recommended Reading

ACIP approves flu vaccine recommendations for 2019-2020 season
MDedge Pediatrics
Cryptosporidiosis infections spike during summer swim season
MDedge Pediatrics
ACIP approves meningococcal booster for persons at increased risk
MDedge Pediatrics
New research in otitis media
MDedge Pediatrics
Legislative, educational interventions influenced vaccine status of California kindergartners
MDedge Pediatrics
LAIV doesn’t up asthmatic children’s risk of lower respiratory events
MDedge Pediatrics
Acquired MMR immunity doesn’t last to age 1 year
MDedge Pediatrics
Parent education improves pediatric influenza vaccination rates
MDedge Pediatrics
CDC: Look for early symptoms of acute flaccid myelitis, report suspected cases
MDedge Pediatrics
Teen mothers using long-acting reversible contraception are least likely to use condoms
MDedge Pediatrics

Related Articles

  • Opinion

    Cellulitis pearls

    How would you treat this patient with cellulitis?