Characteristics of hand infections and predictors of re-presentation and admission from a single tertiary referral center

Purpose: This study aims to identify factors predictive of 60-day re-presentation and admission following hand infection management at a tertiary referral center. Methods: A retrospective chart review for hand infections at one tertiary center between 2018 and 2019 was completed. Diagnoses, demographic characteristics, antibiotic administration, cultures, admission, and re-presentation and subsequent admission were described. The sample was stratified by if they were readmitted within 60 days or not, and clinical characteristics were compared using a Chi-squared test. Relative risk and odds of re-presentation and admission were calculated for these clinical variables. A p-value of <0.05 was considered statistically significant and all analyses were performed using SPSS. Results: 320 patients met inclusion (Table 1). 76.3 % were admitted (mean LOS of 4.06 ± 6.148 days). 45 % of the total cohort underwent bedside I&D, 15.9 % underwent I&D in the operating room. Of 166 cultures, the most common organisms were gram-positive and polymicrobial (Table 2). Table 3 outlines diagnoses and correlating culture data. 60-day re-presentation and admission was 6.9 %, not significantly associated with IV drug use, animal bites, public insurance, transfer status, antibiotic resistance, or polymicrobial infection. Diagnoses most likely to be readmitted presented with concomitant osteomyelitis. Diagnoses most frequently treated with antibiotics that microbes were resistant to frequently presented with concomitant cellulitis or osteomyelitis. Admission was the only patient factor predictive of polymicrobial infection. Conclusion: Re-presentation and admission for hand infection in this cohort was low, correlating to relative success of treatment, and not associated with specific characteristics within our population. Concomitant diagnoses of osteomyelitis or cellulitis the risk of re-presentation and admission or initial treatment with resistant antibiotics. Level of evidence: IV.