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Multicenter Study
. 2011 Aug;202(2):139-45.
doi: 10.1016/j.amjsurg.2010.07.041. Epub 2011 May 4.

Local variations in the epidemiology, microbiology, and outcome of necrotizing soft-tissue infections: a multicenter study

Lillian S Kao  1 , Debbie F Lew, Samer N Arab, S Rob Todd, Samir S Awad, Matthew M Carrick, Michael G Corneille, Kevin P Lally
Affiliations
Multicenter Study

Local variations in the epidemiology, microbiology, and outcome of necrotizing soft-tissue infections: a multicenter study

Lillian S Kao et al. Am J Surg. 2011 Aug.

Abstract

Background: Necrotizing soft-tissue infections (NSTIs) are rare and highly lethal.

Methods: A retrospective chart review of patients with NSTIs treated at 6 academic hospitals in Texas between January 1, 2004 and December 31, 2007. Patient demographics, presentation, microbiology, treatment, and outcome were recorded. Analysis of variance, chi-square test, and logistic regression analysis were performed.

Results: Mortality rates varied between hospitals from 9% to 25% (n = 296). There was significant interhospital variation in patient characteristics, microbiology, and etiology of NSTIs. Despite hospital differences in treatment, primarily in critical care interventions, patient age and severity of disease (reflected by shock requiring vasopressors and renal failure postoperatively) were the main predictors of mortality.

Conclusions: Significant center differences occur in patient populations, etiology, and microbiology of NSTIs, even within a concentrated region. Management should be based on these characteristics given that adjunctive treatments are unproven and variations in outcome are likely because of patient disease at presentation.

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References

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