Original articleA predictive model for diagnosis of lower extremity cellulitis: A cross-sectional study
Section snippets
Selection criteria
This study used the same cohort of patients used in our previous work, in which we performed a retrospective cross-sectional chart review of all patients presenting to and admitted through the ED of a large urban hospital with a diagnosis of lower extremity cellulitis between June 2010 and December 2012.9 Patients were identified by using the Research Patient Data Registry (RPDR), a clinical data registry of all patients within the Partners Healthcare system. Information stored within the RPDR
Patient characteristics
A total of 840 patient encounters of presumed cellulitis were identified, of which 259 met inclusion criteria (Fig 1); 581 patients were excluded from our analysis: 164 patients had skin lesions involving locations other than the lower extremities; 115 patients did not present directly to the ED (they transferred from outside the ED or another hospital); 110 patients had lesions associated with abscesses, penetrating trauma, burns, osteomyelitis, diabetic ulcers, or hardware; 108 patients did
Discussion
In our study, we found that asymmetry (unilateral leg involvement), leukocytosis, tachycardia, and age ≥70 years are predictive of lower extremity cellulitis. Using these 4 criteria, we developed the ALT-70 cellulitis scoring system as a fast and straightforward tool to aid in distinguishing patients with true cellulitis (c-statistic = 0.752). In our cohort, patients with an ALT-70 cellulitis score below 3 have a ≥83.3% likelihood of pseudocellulitis, and the diagnosis of cellulitis should be
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Dr Raff and Dr Weng contributed to this work equally.
Funding sources: None.
Conflicts of interest: None declared.
Reprints not available from the authors.