title: Hyperbaric oxygen therapy in necrotising soft tissue infections: a study of patients in the United States Nationwide Inpatient Sample.
abstract: OBJECTIVE
  Necrotising soft tissue infection (NSTI) is a deadly disease associated with a significant risk of mortality and long-term disability from limb and tissue loss. The aim of this study was to determine the effect of hyperbaric oxygen (HBO(2)) therapy on mortality, complication rate, discharge status/location, hospital length of stay and inflation-adjusted hospitalisation cost in patients with NSTI.
  
  
  METHODS
  This was a retrospective study of 45,913 patients in the Nationwide Inpatient Sample (NIS) from 1988 to 2009.
  
  
  RESULTS
  A total of 405 patients received HBO(2) therapy. The patients with NSTI who received HBO(2) therapy had a lower mortality (4.5 vs. 9.4 %, p = 0.001). After adjusting for predictors and confounders, patients who received HBO(2) therapy had a statistically significantly lower risk of dying (odds ratio (OR) 0.49, 95 % confidence interval (CI) 0.29-0.83), higher hospitalisation cost (US$52,205 vs. US$45,464, p = 0.02) and longer length of stay (LOS) (14.3 days vs. 10.7 days, p < 0.001).
  
  
  CONCLUSIONS
  This retrospective analysis of HBO(2) therapy in NSTI showed that despite the higher hospitalisation cost and longer length of stay, the statistically significant reduction in mortality supports the use of HBO(2) therapy in NSTI.
authors.affiliation: Duke-NUS Graduate Medical School, Singapore, Singapore. rick.soh.chai@sgh.com.sg
authors.forename: Chai R
authors.initials: CR
authors.lastname: Soh
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pietrobon
authors.forename: John J
authors.initials: JJ
authors.lastname: Freiberger
authors.forename: Sophia T
authors.initials: ST
authors.lastname: Chew
authors.forename: Dimple
authors.initials: D
authors.lastname: Rajgor
authors.forename: Mihir
authors.initials: M
authors.lastname: Gandhi
authors.forename: Jatin
authors.initials: J
authors.lastname: Shah
authors.forename: Richard E
authors.initials: RE
authors.lastname: Moon
mesh_terms: D015897:Comorbidity; D005260:Female; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D012189:Retrospective Studies; D018461:Soft Tissue Infections / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology