Mortality in Patients with Necrotizing Fasciitis of the Extremities at Phayao Hospital

Authors

  • Chopong Sukpromson Phayao General Hospital, Thailand

Abstract

Background: Necrotizing fasciitis (NF) of the extremities is one of the most important problems in
Phayao General Hospital due to its high mortality. This study aimed to find the risk factors associated with
mortality in order to manage properly.
Methods: The medical records of 45 patients who admitted with NF between January 2005 and June 2007
were retrospectively reviewed. Demographic data and several potential risk factors were collected. The risk
factors were analyzed by Chi-squared test and Fisher’s Exact Test.
Results: The overall mortality rate was 22.22%. The risk factors that were significantly associated with
high mortality were patients with renal insufficiency (plasma creatinine > 2.0 mg/dl) and patients needed to be
treated in the intensive care unit.
Conclusion: Patients with renal insufficiency and patients needed critical care were associated with high
mortality. Such patients should be intensively observed and treated.

References

1. Daniel A. Anaya E. Surgical infections and choice of
antibiotics. In: Townsend CM, et al, editors. Sabiston Textbook
of Surgery, 17th ed. Philadelphia: B Saunders, 2004:264-6.

2. Hansen SL, Mathes SJ, Young DM. Skin and subcutaneous
tissue. In: Brunicardi FC, et al, editors. Schwartz’s Principles
of Surgery, 8th ed. New York; McGraw-Hill Companies, 2005:
434-5.

3. Golger A, Ching S, Goldsmith CH, Pennie RA, Bain JR.
Mortality in patients with necrotizing fasciitis. Plast Reconstr
Surg 2007;119:1803-7.

4. Kwan MK, Saw A, Chee EK, et al. Necrotizing fasciitis of the
lower limb: an outcome study of surgical treatment. Med J
Malaysia 2006;61(Suppl A):17-20.

5. Wong CH, Chang HC, Pasupathy S, Khin LW, Tan JL, Low CO.
Necrotizing fasciitis: clinical presentation, microbiology, and
determinants of mortality. J Bone Joint Surg Am 2003;85-A:
1454-60.

6. Hefny AF, Eid HO, Al-Hussona M, Idris KM, Abu-Zidan FM.
Necrotizing fasciitis: a challenging diagnosis. Eur J Emerg
Med 2007;14:50-2.

7. Rieger UM, Gugger CY, Farhadi J, et al. Prognostic factors
in necrotizing fasciitis and myositis: analysis of 16 consecutive
cases at a single institution in Switzerland. Ann Plast Surg
2007;58:523-30.

8. Ozalay M, Ozkoc G, Akpinar S, Hersekli MA, Tandogan RN.
Necrotizing soft-tissue infection of a limb: clinical presentation
and factors related to mortality. Foot Ankle Int 2006;27:598-
605.

9. Schroeder JL, Steinke EE. Necrotizing fasciitis—the importance
of early diagnosis and debridement. AORN J 2005;82:
1031-40.

10. Legbo JN, Shehu BB. Necrotizing fasciitis : a comparative
analysis of 56 cases. J Natl Med Assoc 2005;97:1692-7.

11. Tillou A, St Hill CR, Brown C, Velmahos G. Necrotizing soft
tissue infections: improved outcomes with modern care.
Am Surg 2004;70:841-4.

12. Bilton BD, Zibari GB, McMillan RW, Aultman DF, Dunn G,
McDonald JC. Aggressive surgical management of
necrotizing fasciitis serves to decrease mortality: a
retrospective study. Am Surg 1998;64:397-400.

13. Majeski JA, Alexander JW. Early diagnosis, nutritional support,
and immediate extensive debridement improve survival in
necrotizing fasciitis. Am J Surg 1983;145:784-7.

14. Meng Y, Chi CY, Ho MW, et al. Microbiology and factors
affecting mortality in necrotizing fasciitis. J Microbiol Immunol
Infect 2005;38:430-5.

15. Sudarsky LA, Laschinger J, Coppa G, Spencer F. Improved
Results from a standardized approach in treating patients
with necrotizing fasciitis. Ann Surg 1987;206:661-5.

Downloads

Published

2009-06-30

How to Cite

1.
Sukpromson C. Mortality in Patients with Necrotizing Fasciitis of the Extremities at Phayao Hospital. Thai J Surg [Internet]. 2009 Jun. 30 [cited 2024 Apr. 27];30(1-2). Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/227654

Issue

Section

Original Articles