Gender Disparities Emerge in Spanish Cellulitis Care

TOPLINE:

The clinical characteristics and outcomes of cellulitis varied between sexes. Factors such as leukaemia, age ≥ 80 years, neoplasia, cirrhosis, heart failure, neurodegenerative disease, and ischaemic heart disease considerably elevated the risk for mortality.

METHODOLOGY:

• This retrospective analysis assessed hospitalisation rates, sex-specific clinical characteristics, in-hospital mortality and risk factors, and hospitalisation costs for cellulitis.
• Data were sourced from the database of the Spanish Health Ministry and included 194,673 cellulitis-related hospitalisations (90,828 women; median age, 78 years and 103,845 men; median age, 67 years) between March 1, 2016, and December 31, 2022.
• Outcomes included hospital stay durations and hospitalisation costs. Independent factors associated with cellulitis-related hospitalisations and in-hospital mortality were identified in both men and women.

TAKEAWAY:

• Women had a lower overall hospitalisation rate than men (6.0 vs 7.6 per 1000 admissions per year); however, among those aged ≥ 80 years, women had a higher hospitalisation rate than men (11.7 vs 8.3 per 1000 admissions per year).
• Factors strongly associated with cellulitis in women were age 65-79 years or > 80 years, hypertension, dyslipidaemia, obesity, heart failure, hypothyroidism, neurodegenerative diseases, and infections caused by Escherichia coli.
• Major in-hospital mortality risk factors for both men and women included leukaemia, age ≥ 80 years, neoplasia, cirrhosis, heart failure, neurodegenerative disease, and ischemic heart disease. Diabetes mellitus was the factor unique to women, whereas chronic obstructive pulmonary disease was the factor unique to men.
• The median cost per hospitalisation was significantly lower in women (€3653) than in men (€3669; P

IN PRACTICE:

“The higher hospitalisation rate for cellulitis in this age group [women aged ≥ 80 years] may not necessarily indicate greater susceptibility among women. Instead, it could reflect the lower survival rate of men to this age due to other causes of mortality. This potential confounding factor should be considered when interpreting sex differences in hospitalisation rates,” the authors wrote.

SOURCE:

The study was led by Isabel Belinchon-Romero, Department of Clinical Medicine, Miguel Hernandez University, and Department of Dermatology, Dr Balmis General University Hospital, Alicante, Spain. It was published online on February 15, 2025, in the International Journal of Infectious Diseases.

LIMITATIONS:

Hospital discharge records document only admissions, with each admission, including readmissions, counted as a new episode, potentially capturing some patients multiple times. The diagnosis information available for each patient was limited to the set of diagnoses recorded at hospital discharge, with only the most relevant ones typically included. Also, in cases where specific tests or well-defined pathologies were not available, potential inconsistencies and inaccuracies were inevitable.

DISCLOSURES:

The study did not receive any funding, and none of the authors declared any conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.