Non-necrotizing and necrotizing soft tissue infections in South America: A retrospective cohort study

Abstract

Background This study analyzed and described factors related to necrotizing or non-necrotizing soft tissue infections (SSTIs) in a hospitalized patient population in Northeastern South America. Materials and methods This retrospective study included patients hospitalized with SSTIs between January 2011 and December 2016. The main factors related to necrotizing SSTIs (NSTIs) or non-necrotizing SSTIs were analyzed together or separately. Results Of 344 SSTI patients (161 [46.8%] non-necrotizing, 183 [53.2%] necrotizing), NSTI patients had a higher incidence of heart disease ( P = 0.0081) and peripheral arterial disease (PAD; p < 0.001), more antibiotic use, and longer hospital stay ( P < 0.001). NSTI was associated with a 9.58, 33.28, 2.34, and 2.27 times higher risk of PAD (confidence interval [CI] 3.69–24.87), amputation (7.97–139), complications (1.45–3.79), and death (1.2–4.26), respectively, than non-necrotizing SSTI. The risk factors associated with amputation were PAD ( P < 0.001) and poor glycemic control during hospitalization ( P = 0.0011). Factors associated with higher mortality were heart disease ( P < 0.001), smoking ( P = 0.0135), PAD ( P = 0.001), chronic renal failure ( P = 0.0039), poor glycemic control ( P = 0.0005), and evolution to limb irreversibility ( P < 0.001). Conclusion Patients with NSTI have greater illness severity, with a greater association with PAD and amputation. Patients with poor glycemic control more frequently underwent amputation and died.

Necrotizing Soft Tissue Infection: A Single-Center Retrospective Study of Treatment and Outcomes

“…The dominant comorbid diseases in NF are diabetes mellitus (DM), hypertension, and obesity. In addition to them, significant comorbidities that affect the worsening of the prognosis are chronic renal failure, chronic heart disease, alcoholism, immunosuppression, systemic disorders, cirrhosis, local trauma, intravenous drug abuse, malnutrition, peripheral arterial disease [ 19 - 20 ]. In a study by Gonullu et al, more than half of the patients had at least one predisposing comorbidity and the most common (50%) comorbidity factor was diabetes mellitus [ 21 ].…”