Risk factors for onset, recurrence and prolonged hospitalization in patients with cellulitis: a retrospective case-control study

Background Cellulitis is a common soft tissue infection; however, despite its prevalence, associated risk factors are not consistently defined in the literature. Methods We conducted a retrospective case-control study of 1395 cellulitis patients and 667 controls, analyzing risk factors for disease development, recurrent episodes, and prolonged hospitalization using regression models. Results Male gender (2.68; 2.11 to 3.40; p < 0.001), higher baseline age (1.03; 1.02 to 1.03; p < 0.001), tinea pedis (72.48; 20.89 to 251.45; p < 0.001), ulcers (45.79; 13.21 to 158.70; p < 0.001), traumatic wounds (229.26; 14.37 to 3656.53; p < 0.001), stasis dermatitis (10.81; 2.10 to 55.64; p = 0.004), eczema (13.14; 3.50 to 49.32; p < 0.001), venous insufficiency (2.36; 1.29 to 4.32; p = 0.005), lymphoedema (11.21; 3.66 to 34.28; p < 0.001), oedema not otherwise specified (13.12; 2.29 to 75.16; p = 0.004), diabetes mellitus (1.58; 1.09 to 2.30; p = 0.015), chronic kidney disease (2.29; 1.24 to 4.25; p = 0.008), and obesity (2.74; 1.81 to 4.17; p < 0.001) emerged as risk factors for disease onset. Obesity was also a consistent risk factor for multiple disease episodes (1.73; 1.02 to 2.96; p = 0.044) and prolonged hospitalization (1.72; 1.25 to 2.42; p = 0.002). Conclusions Male gender, higher age, skin barrier breaches, oedema, diabetes mellitus, chronic kidney disease, and obesity might be strong risk factors for cellulitis with obesity predisposing also for multiple disease episodes and prolonged hospitalization.