# Clinical characteristics of children hospitalized with cellulitis in Spain (2016–2022). A population-based analysis

## TL;DR

This study analyzed hospitalizations for cellulitis in children in Spain from 2016 to 2022, finding age-related differences in clinical features and costs.

## Contribution

The study provides a population-based analysis of cellulitis in children, highlighting age-specific clinical and economic patterns.

## Key findings

- Hospitalization rates and clinical features of cellulitis vary significantly by age group.
- Younger children had higher ICU admission rates and costs compared to older children.
- Facial cellulitis was more common in younger children, while extremity cellulitis increased with age.

## Abstract

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.

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.

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.

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.