Prognostic Factors in Necrotizing Fasciitis: Insights from a Two-Decade, Two-Center Study Involving 209 Cases
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
4.1. Strengths of the Study
4.2. Limitations of the Study
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Parameters | Study Group (n = 209) |
---|---|
Demographics | |
Age | 58.3 ± 15.1 |
Male | 139 (66.5%) |
Comorbidities and risk factors | |
Diabetes | 85 (40.7%) |
Peripheral vascular diseases | 40 (19.1%) |
Obesity | 46 (22.0%) |
Immunosuppression a | 13 (6.2%) |
Cancer | 20 (9.6%) |
Heart, liver or renal insufficiency | 102 (48.8%) |
Hypertension | 88 (42.1%) |
Alcohol abuse | 23 (11.0%) |
Drug abuse | 18 (8.6%) |
Prior surgery | 40 (19.1%) |
Site of infection | |
Upper Extremity | 38 (18.2%) |
Lower Extremity | 90 (43.1%) |
Cervical | 3 (1.4%) |
Trunk | 17 (8.1%) |
Genital | 45 (21.5%) |
Multiple Sites | 16 (7.7%) |
Causative Microorganisms | |
Polymicrobial | 73 (34.9%) |
Monomicrobial | 101 (48.3%) |
| 67 (32.1%) |
| 34 (16.3%) |
No causative microorganism | 35 (16.7%) |
Laboratory findings | |
C-reactive Protein, mg/dL | 24.2 ± 23.6 |
Leukocyte count, per mm3 | 17.3 ± 13.1 |
Hemoglobin, g/dL | 11.3 ± 2.3 |
Sodium, mmol/L | 135.6 ± 5.9 |
Creatinine, mg/dL | 1.9 ± 1.7 |
Glucose, mg/dL | 179.4 ± 126.6 |
Procalcitonin ng/dL | 14.4 ± 24.6 |
Scoring results | |
Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC score) | 6.1 ± 3.1 |
Laboratory and Anamnestic Risk Indicator for Necrotizing Fasciitis (LARINF score) | 6.1 ± 1.9 |
Clinical outcome | |
Length of hospital stay of survivors, days | 35.6 ± 29.1 |
Admission to intensive care unit | 152 (72.7%) |
Number of deceased patients | 38 (18.2%) |
Parameters | Survivors (n = 171) | Non-Survivors (n = 38) | p-Value |
---|---|---|---|
Demographics | |||
Age, years | 55.9 ± 14.3 | 68.9 ± 13.9 | <0.01 |
Male | 111 (64.9%) | 28 (73.7%) | 0.30 |
Comorbidities and risk factors | |||
Diabetes | 70 (40.9%) | 15 (39.5%) | 0.87 |
Peripheral vascular diseases | 28 (16.4%) | 12 (31.6%) | 0.03 |
Obesity | 36 (21.1%) | 10 (26.3%) | 0.48 |
Immunosuppression | 11 (6.4%) | 2 (5.3%) | 0.79 |
Cancer | 13 (7.6% | 7 (18.4%) | 0.04 |
Heart, liver or renal insufficiency | 71 (41.5%) | 31 (81.6%) | <0.01 |
Hypertension | 67 (39.2%) | 21 (55.3%) | 0.07 |
Alcohol abuse | 15 (8.8%) | 8 (21.1%) | 0.03 |
Drug abuse | 17 (9.9%) | 1 (2.6%) | 0.21 |
Prior surgery | 36 (21.1%) | 4 (10.5%) | 0.14 |
Site of infection | |||
Upper Extremity | 35 (20.5%) | 3 (7.9%) | 0.06 |
Lower Extremity | 67 (39.2%) | 23 (60.5%) | 0.03 |
Cervical | 3 (1.8%) | 0 (0.0%) | 0.40 |
Trunk | 15 (8.8%) | 2 (5.3%) | 0.72 |
Genital | 36 (21.1%) | 9 (23.7%) | 0.50 |
Multiple Sites | 15 (8.8%) | 1 (2.6%) | 0.34 |
Causative Microorganisms a | |||
Polymicrobial | 64 (37.4%) | 9 (23.7%) | 0.15 |
Monomicrobial | 80 (46.8%) | 21 (55.3%) | |
| 57 (33.3%) | 10 (26.3%) | 0.04 |
| 23 (13.5%) | 11 (28.9%) | |
Laboratory findings | |||
C-reactive Protein, mg/dL | 23.5 ± 22.9 | 27.5 ± 26.3 | 0.35 |
Leukocyte count, per mm3 | 16.7 ± 8.4 | 19.5 ± 25.3 | 0.52 |
Hemoglobin, g/dL | 11.4 ± 2.4 | 11.1 ± 2.0 | 0.49 |
Sodium, mmol/L | 135.5 ± 5.8 | 135.9 ± 6.1 | 0.76 |
Creatinine, mg/dL | 1.7 ± 1.6 | 2.5 ± 1.9 | 0.01 |
Glucose, mg/dL | 188.7 ± 136.0 | 137.7 ± 54.7 | <0.01 |
Procalcitonin ng/dL | 14.9 ± 26.3 | 12.6 ± 17.3 | 0.66 |
Scoring results and clinical outcome | |||
Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC score) | 6.0 ± 3.2 | 6.5 ± 2.9 | 0.39 |
Laboratory and Anamnestic Risk Indicator for Necrotizing Fasciitis (LARINF score) | 5.9 ± 1.9 | 6.8 ± 1.6 | 0.02 |
Admission to intensive care unit | 114 (66.7%) | 38 (100%) | <0.01 |
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Megas, I.-F.; Delavari, S.; Marti Edo, A.; Habild, G.; Billner, M.; Reichert, B.; Breidung, D. Prognostic Factors in Necrotizing Fasciitis: Insights from a Two-Decade, Two-Center Study Involving 209 Cases. Infect. Dis. Rep. 2024, 16, 472-480. https://doi.org/10.3390/idr16030035
Megas I-F, Delavari S, Marti Edo A, Habild G, Billner M, Reichert B, Breidung D. Prognostic Factors in Necrotizing Fasciitis: Insights from a Two-Decade, Two-Center Study Involving 209 Cases. Infectious Disease Reports. 2024; 16(3):472-480. https://doi.org/10.3390/idr16030035
Chicago/Turabian StyleMegas, Ioannis-Fivos, Sarina Delavari, Alejandro Marti Edo, Götz Habild, Moritz Billner, Bert Reichert, and David Breidung. 2024. "Prognostic Factors in Necrotizing Fasciitis: Insights from a Two-Decade, Two-Center Study Involving 209 Cases" Infectious Disease Reports 16, no. 3: 472-480. https://doi.org/10.3390/idr16030035