title: Clinical presentations and outcomes of necrotizing fasciitis in males and females over a 13-year period.
abstract: BACKGROUND
  Necrotizing fasciitis (NF) is a rapidly progressive infection of fascia and subcutaneous tissue resulting in serious outcomes. We aimed to evaluate the clinical presentations, hospital course and outcomes of NF based on patient gender.
  
  
  METHODS
  All patients admitted with NF were enrolled in the study over a 13-year period in the main tertiary hospital in Qatar. Clinical presentations, co-morbidities, severity and outcomes were analyzed and compared in male and female patients.
  
  
  RESULTS
  A total of 331 NF patients were identified with a mean age of 51 ± 15 years and male to female ratio of 3:1. However, Arab Qatari females were more frequently affected by NF in comparison to their male counterparts and south Asian females (p < 0.001), respectively. Female patients were older and had significantly higher incidence of abdominal and groin NF (p < 0.004). There were 13 cases with recurrent NF; 85% of them were males. Male NF patients had significantly higher rate of organ failure (p = 0.02), but there was no significant difference in the hospital length of stay as well as mortality in both genders. Overall, there were 85 (25.7%) deaths (23 females and 62 males).
  
  
  CONCLUSIONS
  Necrotizing fasciitis remains a life threatening entity. Although, NF is more common in males, Qatari females are more likely to develop NF than males. NF of abdominal wall and groin is significantly higher in females. Development of organ failure is more common in males with NF. NF remains a challenging clinical problem in Qatar with a mortality rate ranging from 25 to 27% for both genders.
authors.affiliation: Surgical Intensive Care Unit, HGH, Doha, Qatar.
authors.forename: Nissar
authors.initials: N
authors.lastname: Shaikh
authors.affiliation: Clinical Research, Trauma Surgery, HGH, Doha, Qatar ; Clinical Medicine, Weill Cornell Medical School, Doha, Qatar.
authors.forename: Ayman
authors.initials: A
authors.lastname: El-Menyar
authors.affiliation: Trauma Surgery, HGH, Doha, Qatar.
authors.forename: Insolvisagan Natesa
authors.initials: IN
authors.lastname: Mudali
authors.affiliation: Department of Surgery, Hamad General Hospital (HGH), Doha, Qatar.
authors.forename: AbdelHakem
authors.initials: A
authors.lastname: Tabeb
authors.affiliation: Trauma Surgery, HGH, Doha, Qatar ; Department of Surgery, Hamad General Hospital (HGH), Doha, Qatar.
authors.forename: Hassan
authors.initials: H
authors.lastname: Al-Thani
keywords: Clinical presentation; Gender; Necrotizing fasciitis; Outcome; Qatar