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Volume 15, Number 9—September 2009

Dispatch

Trends in US Hospital Admissions for Skin and Soft Tissue Infections

John Edelsberg, Charu Taneja, Marcus Zervos, Nadia Haque, Carol Moore, Katherine Reyes, James Spalding, Jenny Jiang, and Gerry OsterComments to Author 
Author affiliations: Policy Analysis Inc., Brookline, Massachusetts, USA (J. Edelsberg, C. Taneja, J. Jiang, G. Oster); Henry Ford Health System, Detroit, Michigan, USA (M. Zervos, N. Haque, C. Moore, K. Reyes); Astellas Pharma US, Inc., Deerfield, Illinois, USA (J. Spalding)

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Table 2

Number of hospital admissions with principal diagnosis of SSTI, by patient and infection characteristics and year*

Characteristics Year
2000 
(N = 674,939) 2001 
(N = 701,672) 2002 
(N = 757,858) 2003 
(N = 801,768) 2004 
(N = 869,777)
Age, y†
<15 38,420 (5.7) 38,741 (5.5) 44,559 (5.9) 49,902 (6.2) 56,909 (6.5)
15–44 176,574 (26.2) 175,921 (25.1) 197,142 (26.0) 214,606 (26.5) 240,971 (27.7)
45–64 212,367 (31.5) 219,222 (31.2) 247,079 (32.6) 267,556 (33.0) 289,715 (33.3)
>65
247,544 (36.7)
267,768 (38.2)
269,048 (35.5)
277,828 (34.3)
281,288 (32.3)
Sex†
Male 341,040 (50.5) 347,784 (49.6) 381,763 (50.4) 406,525 (50.1) 443,325 (51.0)
Female
333,771 (49.5)
353,849 (50.4)
376,075 (49.6)
400,737 (49.4)
423,255 (48.7)
Race†
White 364,634 (54.0) 368,901 (52.6) 372,013 (49.1) 409,037 (50.5) 439,295 (50.5)
Black 81,654 (12.1) 81,299 (11.6) 94,307 (12.4) 99,892 (12.3) 111,416 (12.8)
Hispanic/Latino 57,217 (8.5) 59,345 (8.5) 63,657 (8.4) 78,091 (9.6) 75,142 (8.6)
Asian or Pacific Islander 6,457 (1.0) 7,219 (1.0) 8,496 (1.1) 9,366 (1.2) 10,053 (1.2)
Native American 2,082 (0.3) 2,375 (0.3) 2,211 (0.3) 1,595 (0.2) 3,890 (0.5)
Other
11,873 (1.8)
11,233 (1.6)
16,304 (2.2)
14,135 (1.7)
13,937 (1.6)
Infection type (ICD-9-CM diagnosis code[s])
Superficial infections 390,158 (57.8) 404,536 (57.7) 440,501 (58.1) 479,222 (59.1) 520,099 (59.8)
Acute lymphadenitis (683.XX) 4,570 (0.7) 4,341 (0.6) 4,230 (0.6) 4,324 (0.5) 4,291 (0.5)
Carbuncle and furuncle (680.XX) 1,001 (0.2) 1,182 (0.2) 1,349 (0.2) 1,900 (0.2) 2,298 (0.3)
Cellulitis and abscess of finger and toe
 (681.XX) 20,060 (3.0) 20,868 (3.0) 22,731 (3.0) 25,174 (3.1) 27,833 (3.2)
Impetigo (684.XX) 1,221 (0.2) 1,084 (0.2) 1,250 (0.2) 1,337 (0.2) 1,481 (0.2)
Infection (chronic) of amputation stump 
 (997.62) 13,431 (2.0) 14,874 (2.1) 15,100 (2.0) 14,459 (1.8) 16,014 (1.8)
Other cellulitis and abscess (682.XX) 346,270 (51.3) 358,884 (51.2) 392,422 (51.8) 428,274 (52.8) 464,016 (53.4)
Other local infections of skin (686.XX) 3,605 (0.5) 3,302 (0.5) 3,419 (0.5) 3,755 (0.5) 4,167 (0.5)
Deeper and/or healthcare-associated 
 infections 274,549 (40.7) 287,736 (41.0) 307,300 (40.6) 320,580 (39.5) 339,337 (39.0)
Abscess of anal and rectal region (566) 20,511 (3.0) 20,273 (2.9) 22,772 (3.0) 23,892 (3.0) 24,655 (2.8)
Chronic ulcer of other specified sites 
 (707.8) 132 (0.0) 75 (0.0) 73 (0.0) 68 (0.0) 62 (0.0)
Chronic ulcer of unspecified site 
 (707.9) 2,136 (0.3) 2,191 (0.3) 2,389 (0.3) 2,666 (0.3) 2,465 (0.3)
Decubitis ulcer (707.0) 37,116 (5.5) 38,637 (5.5) 36,816 (4.9) 38,167 (4.7) 39,706 (4.6)
Infection due to vascular device 
 (996.62) 64,262 (9.5) 73,051 (10.4) 78,289 (10.3) 81,970 (10.1) 91,804 (10.6)
Pilonidal cyst with abscess (685.0) 2,262 (0.3) 2,167 (0.3) 2,447 (0.3) 2,496 (0.3) 2,604 (0.3)
Postoperative wound infection (998.5X) 115,694 (17.1) 120,344 (17.2) 134,783 (17.8) 138,393 (17.1) 144,768 (16.6)
Posttraumatic wound infection, NEC 
 (958.3) 2,748 (0.4) 2,239 (0.3) 1,664 (0.2) 2,326 (0.3) 2,843 (0.3)
Ulcers of lower limbs, except decubitis 
 (707.1X) 29,688 (4.4) 28,759 (4.1) 28,067 (3.7) 30,602 (3.8) 30,431 (3.5)
Often fatal infections 10,232 (1.5) 9,400 (1.3) 10,057 (1.3) 10,965 (1.4) 10,341 (1.2)
Gangrene (785.4) 5,628 (0.8) 4,814 (0.7) 5,155 (0.7) 5,546 (0.7) 4,331 (0.5)
Necrotizing fasciitis (728.86)
4,604 (0.7)
4,586 (0.7)
4,902 (0.7)
5,419 (0.7)
6,010 (0.7)
Hospital region
Northeast 142,316 (21.1) 155,948 (22.2) 158,649 (20.9) 174,481 (21.5) 171,399 (19.7)
Midwest 152,132 (22.5) 159,442 (22.7) 173,353 (22.9) 175,144 (21.6) 193,602 (22.3)
South 253,388 (37.5) 269,323 (38.4) 297,122 (39.2) 316,028 (39.0) 351,721 (40.4)
West
127,102 (18.8)
116,958 (16.7)
128,734 (17.0)
145,115 (17.9)
153,056 (17.6)
Hospital location†
Urban 570,554 (84.5) 592,908 (84.5) 645,261 (85.1) 691,795 (85.3) 755,095 (86.8)
Rural 103,664 (15.4) 108,763 (15.5) 112,597 (14.9) 118,563 (14.6) 114,682 (13.2)

*SSTI, skin and soft tissue infection; ICD-9-CM, International Classification of Diseases, 9th Revision, Clinical Modification; NEC, not elsewhere classified. Numbers are given as no. (%) admissions; N values for each year are provided. Source: Healthcare Cost and Utilization Project National Inpatient Sample, 2000–2004.
†Percentages may not add up to 100% due to missing data.

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