Factors Related to Mortality from Necrotizing Fasciitis at Sawanpracharak Hospital
Keywords:
Risk factors, Mortality, Necrotizing fasciitisAbstract
Objective: To determine the factors associated with necrotizing fasciitis at Sawanpracharak Hospital, Nakhonsawan.
Meterials and Methods: Data were collected from medical records of patients who were diagnosed with necrotizing fasciitis during the period between January 2016 and December 2017. Logistic regression analysis was used to analyze the association between risk factors and mortality.
Results: Factors affecting mortality included hemorrhagic bleb (33.9% vs 66.7%, p value 0.02), hypotension (5.5% vs 40.0%, p value < 0.01), alteration of conscious (3.7% vs 40.0%, p value < 0.01), and acidosis (52.3% vs 86.7%, p value 0.01). Alteration of conscious increased the odds of mortality by 19.2 times (odds ratio 19.2, 95% CI 3.15-117, p value < 0.01).
Conclusion: Factors associated with necrotizing fasciitis at Sawanprachrak Hospital were related to the severity of the disease such as sepsis. It is imperative that there is a quick diagnosis of the infection, followed by an appropriate administrating of antibiotic and surgical interventions to reduce the rate of mortality.
References
McHenry CR, Piotrowski JJ, Petrinic D, Malangoni MA. Determinants of mortality for necrotizing soft-tissue infections. Ann Surg 1995;221:558–63.
Joshy S, Haidar SG, Iossifidis A. Necrotising fasciitis of the shoulder following muscular strain. Int J Clin Pract 2006;60:856–7.
Wong CH, Chang HC, Pasupathy S, et al. Necrotizing fasciitis: clinical presentation, microbiology, and determinants of mortality. J Bone Joint Surg Am 2003;85-A:1454–60.
Tang WM, Ho PL, Fung KK et al. Necrotising fasciitis of a limb. J Bone Joint Surg Br 2001;83:709–14.
Anaya DA, McMahon K, Nathens AB, et al. Predictors of mortality and limb loss in necrotizing soft tissue infections. Arch Surg 2005;140:151–7.
Hongladaromp C, Chareonsil B, Phadhana anake O. Predictors on mortality from necrtizing fasciitis in Sawanpracharak hospital, Nakhonsawan, Thailand. Chiang Mai Med J 2009;48:135-42.
Roje Z, Roje Z, Matic D, et al. Necrotizing fasciitis: literature review of contemporary strategies for diagnosing and management with three case reports: torso, abdominal wall, upper andlower limbs. World J Emerg Surg 2011;6:46.
Huang KF, Hung MH, Lin YS, et al. Independent predictors of mortality for necrotizing fasciitis: a retrospective analysis in a single institution. J Trauma 2011;71:467-73.
Hsiao CT, Weng HH, Yuan YD, et al. Predictors of mortality in patients with necrotizing fasciitis. Am J Emerg Med 2008;26:170–5.
File Jr, Jr TM, Tan JS, DiPersio JR. Group A streptococcal necrotizing fasciitis. Diagnosing and treating the “flesh-eating bacteria syndrome”. Cleve Clin J Med 1998;65: 241-49.
Ellis Simonsen SM, van Orman ER, et al. Cellulitis incidence in a defined population. Epidemiol Infect 2006;134:293-9.
Chan T, Yaghoubian A, Rosing D, et al. Low sensitivity of physical examination findings in necrotizing soft tissue infection is improved with laboratory values: a prospective study. Am J Surg 2008;196: 926-30.
Wallace HA, Waheed A, Perera TB. Necrotizing Fasciitis. In: StatPearls Publishing, Treasure Island (FL); 2019.
Elliott DC, Kufera JA, Myers RA. Necrotizing soft tissue infections. Risk factors for mortality and strategies for management. Am Surg 1996;224:672-83.
Wang YS, Wong CH, Tay YK. Staging of necrotizing fasciitis based on the evolving cutaneous features. Int J Dermatol 2007;46:1036-41.
Scott L. DeBoer, Debi Zeglin. Necrotizing Fasciitis Even with optimal treatment, the mortality rate is 40%. AJN 200;101:37-8.
Sutherland ME, Meyer AA. Necrotizing softtissue infections. Surg Clin North Am 1994; 74:591-607.
Wong CH, Wang YS. The diagnosis of necrotizing fasciitis. Curr Opin Infect Dis 2005;18:101-6.
Tilkorn DJ, Citak M, Fehmer T, et al. Characteristics and differences in necrotizing fasciitis and gas forming myonecrosis: a series of 36 patients. Scand J Surg. 2012;101:51–5.
Wong CH, Khin LW, Heng KS, Low CO. The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections. Crit Care Med 2004;32:1535-41.
Gaby J, Ayman EM, Ruben P, et al. Pattern and predictors of mortality in necrotizing fasciitis patients in a single tertiary hospital. World J of Emerg Surg 2016;11:40.
Elliot D, Kufera JA, Myers RA. The microbiology of necrotizing soft tissue infections. Am J Surg 2000;179:361-6.
Downloads
Published
How to Cite
Issue
Section
License
Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.
