title: Influence of surgical treatment timing on mortality from necrotizing soft tissue infections requiring intensive care management.
abstract: OBJECTIVE
  Surgical treatment is crucial in the management of necrotizing soft tissue infections (NSTIs). The aim of this study was to determine the influence of surgical procedure timing on hospital mortality in severe NSTI.
  
  
  METHODS
  A retrospective study including 106 patients was conducted in a medical intensive care unit equipped with a hyperbaric chamber. Data regarding pre-existing conditions, intensive care and surgical management were included in a logistic regression model to determine independent factors associated with hospital mortality.
  
  
  RESULTS
  Overall hospital mortality was 40.6%. In multivariate analysis, underlying cardiovascular disease, SAPS II, abdominoperineal compared to limb localization, time from the first signs to diagnosis <72 h, and time from diagnosis to surgical treatment >14 h in patients with septic shock were independently associated with hospital mortality.
  
  
  CONCLUSIONS
  In patients with NSTI and septic shock, hospital mortality is influenced by the timing of surgical treatment.
authors.affiliation: Medical Intensive Care Unit, Hôpital Pellegrin-Tripode, Place Amélie Raba Léon, 33076 Bordeaux cedex, France. alexandre.boyer@chu-bordeaux.fr
authors.forename: Alexandre
authors.initials: A
authors.lastname: Boyer
authors.forename: Frederic
authors.initials: F
authors.lastname: Vargas
authors.forename: Fanny
authors.initials: F
authors.lastname: Coste
authors.forename: Elodie
authors.initials: E
authors.lastname: Saubusse
authors.forename: Yves
authors.initials: Y
authors.lastname: Castaing
authors.forename: Georges
authors.initials: G
authors.lastname: Gbikpi-Benissan
authors.forename: Gilles
authors.initials: G
authors.lastname: Hilbert
authors.forename: Didier
authors.initials: D
authors.lastname: Gruson
mesh_terms: D019115:Fasciitis, Necrotizing / Q000453:epidemiology / Q000401:mortality / Q000601:surgery; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000453:epidemiology / Q000401:mortality / Q000601:surgery