Risk factors, clinical characteristics, and outcomes of lower limb cellulitis in a tertiary hospital in Iran

Abstract

Lower limb cellulitis is a frequent bacterial infection associated with substantial morbidity, yet epidemiological data from Iran remain limited. This retrospective cross-sectional study analyzed the medical records of 120 patients admitted to a tertiary hospital in Zanjan, Iran, with lower limb cellulitis between July and December 2023. The mean age was 53.3 years, and 65.0% of the participants were male. The average duration of hospitalization was 6.3 ± 5.4 days. Hypertension (28.3%) and diabetes mellitus (17.5%) were the most common comorbidities. Trauma was the leading precipitating factor, reported in 50.0% of cases, and was significantly more frequent among males (p=0.007). Abscess formation occurred in 29.2% of patients and was strongly associated with trauma (p=0.001) and previous cellulitis (p=0.046). Hypertension and diabetes were more common among female patients, although their older mean age may partially confound this. A history of deep vein thrombosis and recurrent cellulitis was associated with prolonged hospitalization. These findings highlight trauma as the predominant risk factor for cellulitis in this population, with comorbid diabetes further worsening clinical outcomes. The results underscore the need for preventive strategies, including patient education on wound care, strict control of chronic diseases, and targeted interventions for high-risk groups such as diabetic patients and manual laborers. Despite providing valuable regional insight, the study is limited by its retrospective single-center design, reliance on univariate analysis, small subgroup sizes, and potential data inconsistencies. Future prospective, multi-center studies are warranted to validate and expand these observations.