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Clinical characteristics of children hospitalized with cellulitis in Spain (2016-2022). A population-based analysis
Isabel Belinchón-Romero1,2,3, José-Manuel Ramos-Rincón1,3,4,5
1Department of Clinical Medicine, Miguel Hernández University, Alicante, Spain.
Insights
Pediatric cellulitis hospitalizations show varying clinical features by age, with significant healthcare costs, especially for young children. Despite low intensive care unit (ICU) admission and mortality rates, the economic impact is substantial.
Area of Science:
- Pediatric infectious diseases
- Health economics
- Epidemiology
Background:
- Cellulitis is a common bacterial skin infection in children.
- Understanding age-specific characteristics and costs is crucial for resource allocation and management.
- Previous studies have not comprehensively analyzed these aspects in a large pediatric population.
Purpose of the Study:
- To estimate hospitalization rates for pediatric cellulitis.
- To describe the clinical characteristics of cellulitis across different pediatric age groups (0-4, 5-9, 10-14 years).
- To assess the direct healthcare costs associated with these hospitalizations.
Main Methods:
- Retrospective, population-based study utilizing data from the Spanish Registry of Specialist Care Activities (2016-2022).
- Inclusion of patients aged 14 years or younger hospitalized for cellulitis.
- Analysis of demographic data, clinical presentation, predisposing factors, intensive care unit (ICU) admission, mortality, and direct healthcare costs.
Main Results:
- A total of 15,497 hospitalizations were analyzed, with the highest proportion in the 0-4 year age group (47.6%).
- Extremities and facial regions were the most common sites, with varying prevalence by age. Trauma and atopic dermatitis were key predisposing factors.
- Direct healthcare costs totaled €54.7 million, with the youngest age group incurring the highest costs (€28.2 million). ICU admission (2.8%) and mortality (0.1%) were low.
Conclusions:
- The clinical presentation and contributing factors of pediatric cellulitis differ significantly across age groups.
- While severe outcomes like ICU admission and mortality are infrequent, the overall economic burden of pediatric cellulitis hospitalizations is considerable.
- Targeted interventions and resource management strategies may be beneficial, particularly for the youngest pediatric population.
Aim:
To estimate hospitalization rates, describe clinical characteristics, and assess the direct healthcare costs of cellulitis-related hospitalizations in children of different ages: 0-4 years, 5-9 years, and 10-14 years.
Materials And Methods:
This retrospective, population-based study included patients aged 14 years or less and hospitalized for cellulitis in Spain between 2016 and 2022. Data were obtained from the Spanish Registry of Specialist Care Activities provided by the Ministry of Health.
Results:
A total of 15,497 cellulitis-related hospitalizations were included: 7,378 (47.6%) aged 0-4 years, 4,532 (29.2%) aged 5-9 years, and 3,587 (23.1%) aged 10-14 years. The proportion of boys (56.6%) was higher than for girls and increased with age (p < 0.001). The most common anatomical site was the extremities (excluding fingers and toes), comprising 40.9% of cases, with frequency increasing with age (p < 0.001). Facial cellulitis was the second most frequent site (37.4%), but its proportion decreased with age (p < 0.001). The main predisposing factors for infection were trauma and open wounds (13.5%), especially in older children (p < 0.001), along with atopic dermatitis (3.1%). Only 2.8% of children required intensive care unit (ICU) admission, with the highest rates in the youngest group and the lowest in the 5-9-year-old group. In-hospital mortality was consistently low (0.1%) across age groups. The total direct cost of hospitalizations was estimated at €54.7 million: €28.2 million in 0-4-year-olds, €13.7 million in 5-9-year-olds, and €12.8 million in 10-14-year-olds.
Conclusions:
The clinical profile of cellulitis varies by age group. While ICU admission and in-hospital mortality were rare, the economic burden remains substantial, particularly among younger children.
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