老年顏面蜂窩組織炎病患特性分析：與年輕成年人比較

The Characteristics of Facial Cellulitis in Geriatric Patients: Comparison with Young Adults

目的：顏面蜂窩組織炎常見於兒童及年輕族群，但在老年族群中較少相關研究文獻。本研究目的在了解該並在老年患者的特性，並與年輕成年患者作一比較。方法：本研究針對於2005至2007年間，某社區醫院15歲及以上之顏面蜂窩組織炎出院病歷摘要電子檔，進行回溯式分析。結果：於研究期間，共有133名個案及其141筆住院資料納入分析，包含67名男性及66名女性，年齡自15至91歲。高齡組（65歲及以上）佔54人，其餘79人作為年輕成年（對照）組。相較之下，高齡組有顯著較長住院日以及較低之血紅素值(p<0.05)。兩組的微生物培養陽性率均低（高齡組：1.85%；年輕成年組：5.75%）。在顏面蜂窩組織炎住院患者病因分布上，高齡組與年輕成年組有顯著差異(p=0.006)，諸如高齡組有偏高比例之齒源性感染及不明來源感染。相較之下，年輕成年組有偏高的皮膚缺損感染及呼吸道源感染。結論：相較於年輕族群，顏面蜂窩組織炎在老年病患反映了某些特性，諸如較長住院日、低血紅素值、以及病因分布上的差異。在共伴症中，糖尿病、頭頸部腫瘤、及齒源性感染，在兩組間的分布並無顯著差異。

Purpose: Facial cellulitis has been documented in the pediatric/young population, but less often discussed in the elderly. Our study aims to determine the characteristics of facial cellulitis in geriatric patients and to compare them with young adults. Methods: We retrospectively collected electronic discharge summaries for inpatients aged ≥ 15 years who had been admitted to a community hospital from 2005 to 2007 with facial cellulitis. Results: A total of 133 subjects were enrolled, 67 males and 66 females (age 15-91 years), and 141 admission records were examined. Fifty-four subjects aged ≥ 65 years were classified as geriatric, the other 79 as young adult (contrast). Compared with young adult group, the geriatric group had significantly longer hospital stays (>7 days) and lower hemoglobin levels (p<0.05). Positive microorganism culture rates were low in both the geriatric and young adult groups (1.85% and 5.75%, respectively). The distributions of infectious sources differed significantly between the two groups (p=0.006). The geriatric group had a higher ratio of odontogenic infections and unknown sources than the young adult group. In contrast, the young adult group had a higher ratio of skin defect-related infections and respiratory tract infections than the geriatric group. Conclusion: In summary, facial cellulitis revealed several characteristics in geriatric patients such as long hospital stay, low hemoglobin level, and some distributional differences of infecting sources. The instances of co-morbid diabetes mellitus, head/neck tumors, and odontogenic infections did not differ significantly between the two groups.