Ann Surg Treat Res.  2016 Jul;91(1):45-50. 10.4174/astr.2016.91.1.45.

Necrotizing soft tissue infection: analysis of the factors related to mortality in 30 cases of a single institution for 5 years

Affiliations
  • 1Department of Surgery, Postgraduate School of Medicine, Pusan National University, Busan, Korea. kdhun@pusan.ac.kr

Abstract

PURPOSE
Necrotizing soft tissue infection is the infection of the soft tissue with necrotic changes. It is rare, but results in high mortality. We analyzed the characteristics of patients, prognosis, and mortality factors after reviewing 30 cases of a single hospital for 5 years.
METHODS
From January 2009 to December 2013, 30 patients diagnosed with necrotizing fasciitis or Fournier's gangrene in Pusan National University Hospital were enrolled for this study. The following parameters were analyzed retrospectively: demographics, infection site, initial laboratory finding, initial antibiotics, isolated microorganisms, number of surgeries, time to first operation, length of intensive care unit, and total hospital stays.
RESULTS
The overall mortality rate was 23.3%. Mean body mass index (BMI) of the survival group (24.7 ± 5.0 kg/m2) was significantly higher than the nonsurvival group (22.0 ± 1.4 kg/m2, P = 0.029). When BMI was less than 23 kg/m2, the mortality rate was significantly higher (P = 0.025). Two patients (6.7%) with chronic kidney disease requiring hemodialysis died (P = 0.048). Initial WBC count (>13×103/µL), CRP (>26.5 mg/dL), and platelet (PLT) count (<148×103/µL) were found to have negative impact on the prognosis of necrotizing soft tissue infection. Factors such as potassium level, blood urea nitrogen (>27.6 mg/dL), serum creatinine (>1.2 mg/dL) that reflected kidney function were significant mortality factors.
CONCLUSION
Patients with low BMI or abnormal values of WBC count, CRP, and PLT count reflecting the degree of infection or abnormal renal function will need more intensive care.

Keyword

Soft tissue infection; Necrotizing fasciitis; Fournier gangrene

MeSH Terms

Anti-Bacterial Agents
Blood Platelets
Blood Urea Nitrogen
Body Mass Index
Busan
Creatinine
Critical Care
Demography
Fasciitis, Necrotizing
Fournier Gangrene
Humans
Intensive Care Units
Kidney
Length of Stay
Mortality*
Potassium
Prognosis
Renal Dialysis
Renal Insufficiency, Chronic
Retrospective Studies
Soft Tissue Infections*
Anti-Bacterial Agents
Creatinine
Potassium

Cited by  1 articles

Analysis of prognostic factors affecting poor outcomes in 41 cases of Fournier gangrene
Hyung Min Hahn, Kwang Sik Jeong, Dong Ha Park, Myong Chul Park, Il Jae Lee
Ann Surg Treat Res. 2018;95(6):324-332.    doi: 10.4174/astr.2018.95.6.324.


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