Infectious diseases specialist management improves outcomes for outpatients diagnosed with cellulitis in the emergency department: a double cohort study
| Autor: | Seyed M Hosseini-Moghaddam, Kaveri Gupta, Guy W. Thompson, Robert Dagnone, Michael Silverman, Philip Dwek, Sameer Elsayed, Shilpa R. Jain, Kelly Hutt |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Microbiology (medical) medicine.medical_specialty Referral Cohort Studies 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Internal medicine Outpatients Ambulatory Care medicine Humans 030212 general & internal medicine Intensive care medicine Referral and Consultation Retrospective Studies Infection Control business.industry Significant difference Cellulitis Retrospective cohort study General Medicine Emergency department Middle Aged medicine.disease Anti-Bacterial Agents Hospitalization Logistic Models Infectious Diseases Infectious disease (medical specialty) Cohort Administration Intravenous Female Emergency Service Hospital business Cohort study |
| Zdroj: | Diagnostic Microbiology and Infectious Disease. 87:371-375 |
| ISSN: | 0732-8893 |
| DOI: | 10.1016/j.diagmicrobio.2016.12.015 |
| Popis: | Three hospital emergency rooms (ERs) routinely referred all cases of cellulitis requiring outpatient intravenous antibiotics, to a central ER-staffed cellulitis clinic. We performed a retrospective cohort study of all patients seen by the ER clinic in the last 4months preceding a policy change (ER management cohort [ERMC]) (n=149) and all those seen in the first 3months of a new policy of automatic referral to an infectious disease (ID) specialist-supervised cellulitis clinic (ID management cohort [IDMC]) (n=136). Fifty-four (40%) of 136 patients in the IDMC were given an alternative diagnosis (noncellulitis), compared to 16 (11%) of 149 in the ERMC (P0.0001). Logistic regression-demonstrated rates of disease recurrence were lower in the IDMC than the ERMC (hazard ratio [HR], 0.06; P=0.003), as were rates of hospitalization (HR, 0.11; P=0.01). There was no significant difference in mortality. Automatic ID consultation for cellulitis was beneficial in differentiating mimickers from true cellulitis, reducing recurrence, and preventing hospital admissions. |
| Databáze: | OpenAIRE |
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