The epidemiology of necrotizing fasciitis including factors associated with death and amputation

The high morbidity and mortality of necrotizing fasciitis (NF) supports the need for epidemiological studies to characterize the disease and identify patient factors associated with adverse outcomes. A multi-site medical record review of patients diagnosed with NF was performed (n=80, mortality 15%)...

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Bibliographic Details
Published in:Epidemiology and infection 2009-11, Vol.137 (11), p.1609-1614
Main Authors: DWORKIN, M. S., WESTERCAMP, M. D., PARK, L., McINTYRE, A.
Format: Article
Language:English
Subjects:
Adult
Age Factors
Aged
Amputation
Amputation - mortality
Antimicrobial agents
Bacterial infections
Biological and medical sciences
Chicago - epidemiology
Clostridium Infections - mortality
Comorbidity
Diabetes mellitus
Disease
Fasciitis, Necrotizing - complications
Fasciitis, Necrotizing - mortality
Fasciitis, Necrotizing - surgery
Fatalities
Female
Fundamental and applied biological sciences. Psychology
Hospitalization
Hospitals
Humans
Infections
Male
Medical prognosis
Medical records
Microbiology
Middle Aged
Mortality
Necrotizing fasciitis
Odds Ratio
Patients
Retrospective Studies
Risk Factors
Sepsis - complications
Sepsis - mortality
Sex Factors
Streptococcal Infections - mortality
streptococcus
Streptococcus pyogenes - isolation & purification
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Summary:The high morbidity and mortality of necrotizing fasciitis (NF) supports the need for epidemiological studies to characterize the disease and identify patient factors associated with adverse outcomes. A multi-site medical record review of patients diagnosed with NF was performed (n=80, mortality 15%). Variables collected were hypothesized to have association with adverse outcomes from NF, and multivariable analysis was used to detect any such association in this population. Select factors associated with mortality included evidence of underlying conditions (P=0·002), advanced age (P=0·04), young age (P=0·03), and evidence of sepsis (P=0·006). Select factors associated with amputation included diabetes mellitus (P=0·006), evidence of underlying conditions (P=0·03), and cutaneous gangrene noted on admission (P=0·006). These findings demonstrate the important association of NF and extremes of age with mortality and morbidity and support the value of early suspicion with prompt diagnosis and treatment in order to prevent adverse outcomes since the associated risk factors are not immediately modifiable.
ISSN:0950-2688
1469-4409
DOI:10.1017/S0950268809002532