title: Does spinal cord injury influence the mortality rate in patients with necrotizing fasciitis?
abstract: METHODS
  Retrospective chart review.
  
  
  OBJECTIVE
  This study was performed to compare the outcome, especially the mortality rate, in patients with and without spinal cord injury (SCI) and necrotizing fasciitis (NF).
  
  
  METHODS
  Division of Spinal Cord Injury and Department of Plastic and Hand Surgery, BG-University Hospital Bergmannsheil Bochum, Ruhr-University Bochum, Germany.
  
  
  METHODS
  Twenty-five patients with SCI and thirty patients without SCI treated with NF were included in the study. Mean length of hospital stay, mean age, mean laboratory risk indicator for necrotizing fasciitis (LRINEC) score, mean number of surgical debridements, co-morbidity factors and mortality rate were compared between both groups.
  
  
  RESULTS
  There were no differences for the mean LRINEC score (P=0.07), mean number of surgical debridements (P=0.18) and co-morbidities (odds ratio=2.32; 95% confidence interval =0.78-6.92) between both groups. Patients with SCI were significantly younger than patients without SCI (P=0.02). Patients without SCI had a higher mortality risk rate (n=9) than patients with SCI (n=2) (relative risk=1.71; 95% confidence interval =1.13-2.6).
  
  
  CONCLUSIONS
  In conclusion, SCI patients have a lower mortality rate than patients without SCI. Age may influence the mortality rate. Nevertheless, we believe that further unknown risk factors might influence the mortality, especially in patients with SCI.
authors.affiliation: Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany. mcitak@gmx.de
authors.forename: M
authors.initials: M
authors.lastname: Citak
authors.forename: T
authors.initials: T
authors.lastname: Fehmer
authors.forename: M
authors.initials: M
authors.lastname: Backhaus
authors.forename: J
authors.initials: J
authors.lastname: Hauser
authors.forename: R
authors.initials: R
authors.lastname: Meindl
authors.forename: T A
authors.initials: TA
authors.lastname: Schildhauer
authors.forename: H-U
authors.initials: HU
authors.lastname: Steinau
authors.forename: D J
authors.initials: DJ
authors.lastname: Tilkorn
mesh_terms: D000328:Adult; D017677:Age Distribution; D015897:Comorbidity; D003646:Debridement / Q000706:statistics & numerical data; D019115:Fasciitis, Necrotizing / Q000401:mortality* / Q000601:surgery*; D005260:Female; D006801:Humans; D016867:Immunocompromised Host / Q000502:physiology; D007902:Length of Stay / Q000706:statistics & numerical data / Q000639:trends; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D012086:Reoperation / Q000706:statistics & numerical data / Q000639:trends; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013119:Spinal Cord Injuries / Q000276:immunology / Q000401:mortality* / Q000503:physiopathology; D015996:Survival Rate