What factors affect the length of hospitalization in patients with erysipelas? A 10-year retrospective study of patients hospitalized in Lower Silesia, Poland

Abstract

Background. Erysipelas is an acute skin infection caused by group A and G streptococci. This infection is associated with many comorbidities and often requires hospitalization. Objectives. The aim of this study was to identify the factors related to the length of hospitalization in patients with erysipelas. Materials and methods. This retrospective study included 153 admissions of 135 patients (63 women and 72 men) hospitalized due to erysipelas from January 2010 to December 2019. Clinical symptoms, test results, comorbidities, and antibiotic treatments were taken into consideration as factors affecting the length of hospital stay. Results. The median length of hospitalization was 10 days (interquartile range (IQR) = 7–14). Women spent less time in the ward, but the difference was not significant. Features such as tinea pedis (15.5 days, IQR = 13.5–20; p = 0.002), anemia (11 days, IQR = 9–15; p = 0.02), chills (12 days, IQR = 9–15; p = 0.03), elevated serum C-reactive protein (CRP) level over 100 mg/L (11 days, IQR = 8–17; p = 0.02), and leukocytosis (11 days, IQR = 8–15, p = 0.005) were identified as prolonged hospitalization factors. Moreover, patients with erysipelas localized to the legs (p = 0.01) and with a gangrenous variant of erysipelas (p = 0.03) were hospitalized longer. The first-choice antibiotic was not significant in terms of prolonged hospitalization. Patients treated with clindamycin during hospitalization, regardless of whether it was a first-line or subsequent antibiotic, stayed in the ward significantly longer (p = 0.005). Conclusions. Patients suffering from erysipelas with the features identified above, have a higher risk of a prolonged stay in the hospital. Significantly increased inflammatory factors, anemia and tinea pedis contributed to prolonged hospitalization.