Evaluation of Clinical Outcomes in Patients Admitted With Cellulitis in a Surgical Unit of the National Hospital of Sri Lanka

Introduction Cellulitis is a common and potentially serious bacterial infection of the skin and subcutaneous tissues, often leading to notable morbidity, particularly among hospitalized patients. This study evaluated clinical outcomes of patients admitted with cellulitis to surgical wards, identified risk factors for poor prognosis, and assessed the impact of comorbidities and treatment approaches. Methods A retrospective cohort study was conducted on 120 patients admitted with lower limb cellulitis over six months at the National Hospital of Sri Lanka. Data on demographics, comorbidities, cellulitis severity (CREST criteria), complications, treatment modalities, and outcomes were analyzed using SPSS version 25. Results Among the 120 patients, 54% were male, with a mean age of 59 years (IQR 48-68). Diabetes mellitus was the most frequent comorbidity (54%). Most presented with Grade II cellulitis (43.3%). All received intravenous antibiotics and 50% of them underwent surgery. Complications occurred in 28%: including abscess (12%), necrotizing fasciitis (8%), sepsis (8%) and one death (0.8%). Three factors were independently associated with the occurrence of complications: a higher CREST grade (aOR 3.25, 95% CI 1.42–7.45), leukocytosis (aOR 2.11, 95% CI 1.01–4.43), and elevated creatinine (aOR 3.89, 95% CI 1.62–9.32). The median length of stay (LOS) was 6 days (IQR 4–9). Surgery (IRR 2.18, 95% CI 1.62–2.92), higher CREST grade (IRR 1.34, 95% CI 1.09–1.64), and diabetes (IRR 1.28, 95% CI 1.01–1.62) were independently associated with prolonged hospital stay. Thirty-day readmission occurred in 12%. Conclusion Cellulitis remains a major cause of surgical admissions, with outcomes influenced by severity and comorbidities, particularly diabetes. Early diagnosis and tailored management can improve patient prognosis, highlighting the need for standardized national treatment protocols and enhanced clinician training in Sri Lanka.