Necrotizing soft tissue infections: APACHE II score, dissemination, and survival.
BACKGROUND
First described more than a century ago, necrotizing soft tissue infections (NSTIs) continue to cause high mortality and morbidity. The aim of this study was to elucidate the factors affecting the outcome of patients presenting with an NSTI.


METHODS
To determine the factors affecting mortality from NSTIs, the records of 67 patients were retrospectively assessed for the following parameters: age, sex, time between initiation of symptoms and admission to the clinic, presence of systemic coexisting disease, APACHE II score, origin of infection, dissemination of the NSTI, and method of therapy.


RESULTS
The patients were 41 men (61.2%) and 26 women (38.8%) with a mean age of 54.9 +/- 1.73 years. The overall mortality rate was 49% (33/67). Multivariate analysis determined that APACHE II scores of 13 or higher (p = 0.001) and NSTI dissemination (p = 0.02) were risk factors affecting the mortality of patients with NSTIs.


CONCLUSIONS
By considering these two factors, more accurate outcome prediction may be possible, which may be useful for directing the management of patients with NSTIs.
Yilmazlar
Tuncay
T
Department of General Surgery, Uludag University School of Medicine, Gorukle Kampusu, Bursa, 21900, Turkey. tunyil@uludag.edu.tr.|Uludag Universitesi Tip Fak. Genel Cerrahi ABD, Gorukle, Bursa, Turkey. tunyil@uludag.edu.tr.
Ozturk
Ersin
E
Department of General Surgery, Uludag University School of Medicine, Gorukle Kampusu, Bursa, 21900, Turkey.
Alsoy
Alpaslan
A
Department of General Surgery, Uludag University School of Medicine, Gorukle Kampusu, Bursa, 21900, Turkey.
Ozguc
Halil
H
Department of General Surgery, Uludag University School of Medicine, Gorukle Kampusu, Bursa, 21900, Turkey.
D018806:APACHE; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003646:Debridement; D019115:Fasciitis, Necrotizing / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012867:Skin / Q000473:pathology; D018461:Soft Tissue Infections / Q000145:classification / Q000175:diagnosis* / Q000382:microbiology / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents