Rachael S Nightingale MBChB, Nimai Etheridge MBBS, Amy L Sweeny BSc, MPH, RN, Graham Smyth, William Dace BMBCh, BA, Richard A.F. Pellatt MBChB, BA (Hons), FACEM, Peter J Snelling BSc, MBBS (Hons), MHPTM, GCHS, CCPU, FRACP, FACEM, Krishan Yadav MD, MSc, FRCPC, Gerben Keijzers MSc, MBBS, FACEM, PhD
{"title":"急诊科蜂窝织炎:一项以患者为中心的前瞻性队列研究。","authors":"Rachael S Nightingale MBChB, Nimai Etheridge MBBS, Amy L Sweeny BSc, MPH, RN, Graham Smyth, William Dace BMBCh, BA, Richard A.F. Pellatt MBChB, BA (Hons), FACEM, Peter J Snelling BSc, MBBS (Hons), MHPTM, GCHS, CCPU, FRACP, FACEM, Krishan Yadav MD, MSc, FRCPC, Gerben Keijzers MSc, MBBS, FACEM, PhD","doi":"10.1111/1742-6723.14401","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>There is substantial practice variation in the management of cellulitis with limited prospective studies describing the course of cellulitis after diagnosis. We aimed to describe the demographics, clinical features (erythema, warmth, swelling and pain), patient-reported disease trajectory and medium-term follow-up for ED patients with cellulitis.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Prospective observational cohort study of adults diagnosed with cellulitis in two EDs in Southeast Queensland, Australia. Patients with (peri)orbital cellulitis and abscess were excluded. Data were obtained from a baseline questionnaire, electronic medical records and follow-up questionnaires at 3, 7 and 14 days. Clinician adjudication of day 14 cellulitis cure was compared to patient assessment. Descriptive analyses were conducted.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Three-hundred patients (mean age 50 years, SD 19.9) with cellulitis were enrolled, predominantly affecting the lower limb (75%). Cellulitis features showed greatest improvement between enrolment and day 3. Clinical improvement continued gradually at days 7 and 14 with persistent skin erythema (41%) and swelling (37%) at day 14. Skin warmth was the feature most likely to be resolved at each time point. There was a discrepancy in clinician and patient assessment of cellulitis cure at day 14 (85.8% <i>vs.</i> 52.8% cured).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>A clinical response of cellulitis features can be expected at day 3 with ongoing slower improvement over time. Over one third of patients had erythema or swelling at day 14. Patients are less likely than clinicians to deem their cellulitis cured at day 14. Future research should include parallel patient and clinician evaluation of cellulitis to help develop clearer definitions of treatment failure and cure.</p>\n </section>\n </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":null,"pages":null},"PeriodicalIF":1.7000,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.14401","citationCount":"0","resultStr":"{\"title\":\"Cellulitis in the Emergency Department: A prospective cohort study with patient-centred follow-up\",\"authors\":\"Rachael S Nightingale MBChB, Nimai Etheridge MBBS, Amy L Sweeny BSc, MPH, RN, Graham Smyth, William Dace BMBCh, BA, Richard A.F. Pellatt MBChB, BA (Hons), FACEM, Peter J Snelling BSc, MBBS (Hons), MHPTM, GCHS, CCPU, FRACP, FACEM, Krishan Yadav MD, MSc, FRCPC, Gerben Keijzers MSc, MBBS, FACEM, PhD\",\"doi\":\"10.1111/1742-6723.14401\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>There is substantial practice variation in the management of cellulitis with limited prospective studies describing the course of cellulitis after diagnosis. We aimed to describe the demographics, clinical features (erythema, warmth, swelling and pain), patient-reported disease trajectory and medium-term follow-up for ED patients with cellulitis.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Prospective observational cohort study of adults diagnosed with cellulitis in two EDs in Southeast Queensland, Australia. Patients with (peri)orbital cellulitis and abscess were excluded. Data were obtained from a baseline questionnaire, electronic medical records and follow-up questionnaires at 3, 7 and 14 days. Clinician adjudication of day 14 cellulitis cure was compared to patient assessment. Descriptive analyses were conducted.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Three-hundred patients (mean age 50 years, SD 19.9) with cellulitis were enrolled, predominantly affecting the lower limb (75%). Cellulitis features showed greatest improvement between enrolment and day 3. Clinical improvement continued gradually at days 7 and 14 with persistent skin erythema (41%) and swelling (37%) at day 14. Skin warmth was the feature most likely to be resolved at each time point. There was a discrepancy in clinician and patient assessment of cellulitis cure at day 14 (85.8% <i>vs.</i> 52.8% cured).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>A clinical response of cellulitis features can be expected at day 3 with ongoing slower improvement over time. Over one third of patients had erythema or swelling at day 14. Patients are less likely than clinicians to deem their cellulitis cured at day 14. 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Cellulitis in the Emergency Department: A prospective cohort study with patient-centred follow-up
Objective
There is substantial practice variation in the management of cellulitis with limited prospective studies describing the course of cellulitis after diagnosis. We aimed to describe the demographics, clinical features (erythema, warmth, swelling and pain), patient-reported disease trajectory and medium-term follow-up for ED patients with cellulitis.
Methods
Prospective observational cohort study of adults diagnosed with cellulitis in two EDs in Southeast Queensland, Australia. Patients with (peri)orbital cellulitis and abscess were excluded. Data were obtained from a baseline questionnaire, electronic medical records and follow-up questionnaires at 3, 7 and 14 days. Clinician adjudication of day 14 cellulitis cure was compared to patient assessment. Descriptive analyses were conducted.
Results
Three-hundred patients (mean age 50 years, SD 19.9) with cellulitis were enrolled, predominantly affecting the lower limb (75%). Cellulitis features showed greatest improvement between enrolment and day 3. Clinical improvement continued gradually at days 7 and 14 with persistent skin erythema (41%) and swelling (37%) at day 14. Skin warmth was the feature most likely to be resolved at each time point. There was a discrepancy in clinician and patient assessment of cellulitis cure at day 14 (85.8% vs. 52.8% cured).
Conclusions
A clinical response of cellulitis features can be expected at day 3 with ongoing slower improvement over time. Over one third of patients had erythema or swelling at day 14. Patients are less likely than clinicians to deem their cellulitis cured at day 14. Future research should include parallel patient and clinician evaluation of cellulitis to help develop clearer definitions of treatment failure and cure.
期刊介绍:
Emergency Medicine Australasia is the official journal of the Australasian College for Emergency Medicine (ACEM) and the Australasian Society for Emergency Medicine (ASEM), and publishes original articles dealing with all aspects of clinical practice, research, education and experiences in emergency medicine.
Original articles are published under the following sections: Original Research, Paediatric Emergency Medicine, Disaster Medicine, Education and Training, Ethics, International Emergency Medicine, Management and Quality, Medicolegal Matters, Prehospital Care, Public Health, Rural and Remote Care, Technology, Toxicology and Trauma. Accepted papers become the copyright of the journal.