Temporal and seasonal trends of hospitalization and mortality associated with necrotizing fasciitis: A retrospective study of 12 years (2002–2013)

Mekkodathil, Ahammed; El‐Menyar, Ayman; Mudali, Insolvisagan Natesa; Al-Sulaiti, Maryam; Shaikh, Nissar; Al-Thani, Hassan

doi:10.5339/qmj.2020.37

Qatar Medical Journal

2021

DOI: 10.5339/qmj.2020.37

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Temporal and seasonal trends of hospitalization and mortality associated with necrotizing fasciitis: A retrospective study of 12 years (2002–2013)

Ahammed Mekkodathil

Ayman El‐Menyar

Insolvisagan Natesa Mudali

et al.

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“…Necrotizing fasciitis (NF) is a potentially fatal, rapidly progressive disease, with a previously reported mortality rate of up to 76%, and even 100% fatality if not adequately treated. As a result of developments in modern technology and treatment, the mortality rate is approximately 10% to 30% now 1–4 . Patients with infectious diseases frequently experience shock, intensive care unit (ICU) admission, and aggressive surgical intervention, including amputation 5,6 .…”

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Prognostic Role of Subsequent Thrombocytopenia in Necrotizing Fasciitis Without Liver Disease

et al. 2022

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Background: Necrotizing fasciitis (NF) is a life-threatening disease with a fulminant presentation. Although early diagnosis can be aided by combining physical examination, the Laboratory Risk Indicator for Necrotizing Fasciitis score, and computed tomography, a mortality rate of 30% is still reported. In the modern times, an economical and efficient biomarker for predicting mortality in NF patients is still lacking. Platelet count is typically measured in routine blood tests and aids in predicting disease severity. We aimed to clarify the role of platelet count as a predictive factor for aspects of prognosis, such as mortality and surgical outcomes, in patients with NF. Methods: We identified 285 patients with NF between 2018 and 2020 in a single medical center in southern Taiwan. Medical records were collected for the evaluation of patients with thrombocytopenia. Univariate and multivariate analyses were performed for different outcomes. Results: We included 115 patients with confirmed diagnoses of NF. Twelve patients died with a mortality rate of 10.4%. Patients with thrombocytopenia exhibited a higher mortality rate (20.9% vs 4.2%, P = 0.006), more shock episodes (51.2% vs 11.1%, P < 0.001), higher intensive care unit admission rate (46.5% vs 13.9%, P < 0.001), and longer hospital length of stay (37.49 ± 24.12 days vs 28.82 ± 14.63 days, P = 0.037) than those without thrombocytopenia. All patients infected with Vibrio species exhibited thrombocytopenia. In multivariate analysis, independent risk factors for mortality were thrombocytopenia (odds ratio, 4.57; 95% confidence interval, 1.08-19.25) and single gram-negative bacterial culture from the wound (odds ratio 6.88; 95% confidence interval, 1.58-29.96). Conclusions: In patients with NF and subsequent thrombocytopenia, a higher mortality rate, greater numbers of shock episodes, higher demand for intensive care unit, and longer hospital length of stay were observed than in those without thrombocytopenia. In patients with NF, platelet count is a valuable and economic indicator of prognosis. Once thrombocytopenia developed in patients with necrotizing fasciitis, aggressive antibiotic treatment and surgical management are required to improve the chances of recovery.

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Prognostic Role of Subsequent Thrombocytopenia in Necrotizing Fasciitis Without Liver Disease

et al. 2022

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Temporal and seasonal trends of hospitalization and mortality associated with necrotizing fasciitis: A retrospective study of 12 years (2002–2013)

Cited by 1 publication

References 0 publications

Prognostic Role of Subsequent Thrombocytopenia in Necrotizing Fasciitis Without Liver Disease

Prognostic Role of Subsequent Thrombocytopenia in Necrotizing Fasciitis Without Liver Disease

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