Factors Associated With Observation Unit Admission in Emergency Department Patients With Skin and Soft Tissue...

Area of Science:

• Emergency Medicine
• Infectious Diseases
• Clinical Epidemiology

Background:

• Skin and soft tissue infections (SSTIs) are common in emergency departments (EDs), with some patients requiring observation unit (OU) admission.
• Optimizing patient disposition from the ED is crucial for effective care and resource allocation.

Purpose of the Study:

• To identify factors associated with observation unit (OU) admission for patients with skin and soft tissue infections (SSTIs) initially managed in the emergency department (ED).

Main Methods:

• A retrospective cohort study analyzed 1675 patients with SSTIs treated in an urban, tertiary care ED from 2017-2019.
• Logistic regression models were used to identify predictors of OU admission, adjusting for demographic and clinical variables.

Main Results:

• 20.7% of SSTI patients were admitted to the OU.
• Significant predictors of OU admission included older age, immunocompromised status, extremity cellulitis (lower and upper), surgical consultation, and prehospital methicillin-resistant Staphylococcus aureus (MRSA) antibiotic prescription.

Conclusions:

• Key factors influencing OU admission for SSTIs have been identified, offering insights into clinical decision-making.
• Future research should focus on predictors of hospital admission, OU failure, and optimizing antimicrobial selection to improve outcomes.