Predictors of Mortality in Patients With Necrotizing Fasciitis: A Literature Review and Multivariate Analysis

• Published in: Canadian journal of plastic surgery 2023-08, Vol.31 (3), p.221-228
• Main Authors: Kjaldgaard, Lindsey, Cristall, Nora, Gawaziuk, Justin P., Kohja, Zeenib, Logsetty, Sarvesh
• Format: Article
• Language: English
• Subjects: Mortality; Multivariate analysis; Necrotizing fasciitis; Original
• ISSN: 2292-5503; 2292-5511
• DOI: 10.1177/22925503211034830

Background: Necrotizing fasciitis (NF) is a life-threatening infectious disease that can result in significant morbidity and mortality. Previously identified factors have not been verified in a large population. The objective of this study is to further examine the relationship of patient factors in NF mortality. Methods: This study is a retrospective review on patients ≥18 years old diagnosed with NF at the provincial referral centres from 2004 to 2016. The following data were examined: demographics, comorbidities, laboratory values, length of stay, and inhospital mortality. Results: Three hundred forty patients satisfied the inclusion criteria: 297 survived and were discharged, 43 died in hospital. In multivariate analysis, a prognostic model for NF mortality identified age >60 years, elevated creatinine, abnormal blood platelets, and group A β-hemolytic Streptococcus (GABS) infection. Conclusions: Multiple factors were associated with mortality in NF. The strongest univariate association with mortality was age >60 years. In addition, a history of hypertension and/or dyslipidemia, renal disease, and the presence of GABS contributed to a predictive model for inhospital NF mortality.