title: Necrotizing soft tissue infection: analysis of the factors related to mortality in 30 cases of a single institution for 5 years.
abstract: OBJECTIVE
  Necrotizing soft tissue infection is the infection of the soft tissue with necrotic changes. It is rare, but results in high mortality. We analyzed the characteristics of patients, prognosis, and mortality factors after reviewing 30 cases of a single hospital for 5 years.
  
  
  METHODS
  From January 2009 to December 2013, 30 patients diagnosed with necrotizing fasciitis or Fournier's gangrene in Pusan National University Hospital were enrolled for this study. The following parameters were analyzed retrospectively: demographics, infection site, initial laboratory finding, initial antibiotics, isolated microorganisms, number of surgeries, time to first operation, length of intensive care unit, and total hospital stays.
  
  
  RESULTS
  The overall mortality rate was 23.3%. Mean body mass index (BMI) of the survival group (24.7 ± 5.0 kg/m(2)) was significantly higher than the nonsurvival group (22.0 ± 1.4 kg/m(2), P = 0.029). When BMI was less than 23 kg/m(2), the mortality rate was significantly higher (P = 0.025). Two patients (6.7%) with chronic kidney disease requiring hemodialysis died (P = 0.048). Initial WBC count (>13×10(3)/µL), CRP (>26.5 mg/dL), and platelet (PLT) count (<148×10(3)/µL) were found to have negative impact on the prognosis of necrotizing soft tissue infection. Factors such as potassium level, blood urea nitrogen (>27.6 mg/dL), serum creatinine (>1.2 mg/dL) that reflected kidney function were significant mortality factors.
  
  
  CONCLUSIONS
  Patients with low BMI or abnormal values of WBC count, CRP, and PLT count reflecting the degree of infection or abnormal renal function will need more intensive care.
authors.affiliation: Department of Surgery, Postgraduate School of Medicine, Pusan National University, Busan, Korea.
authors.forename: Sung Jin
authors.initials: SJ
authors.lastname: Park
authors.affiliation: Department of Surgery, Postgraduate School of Medicine, Pusan National University, Busan, Korea.
authors.forename: Dong Heon
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Surgery, Postgraduate School of Medicine, Pusan National University, Busan, Korea.
authors.forename: Chang In
authors.initials: CI
authors.lastname: Choi
authors.affiliation: Department of Surgery, Postgraduate School of Medicine, Pusan National University, Busan, Korea.
authors.forename: Sung Pil
authors.initials: SP
authors.lastname: Yun
authors.affiliation: Department of Surgery, Postgraduate School of Medicine, Pusan National University, Busan, Korea.
authors.forename: Jae Hun
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Surgery, Postgraduate School of Medicine, Pusan National University, Busan, Korea.
authors.forename: Hyung Il
authors.initials: HI
authors.lastname: Seo
authors.affiliation: Department of Surgery, Postgraduate School of Medicine, Pusan National University, Busan, Korea.
authors.forename: Hong Jae
authors.initials: HJ
authors.lastname: Jo
authors.affiliation: Department of Surgery, Postgraduate School of Medicine, Pusan National University, Busan, Korea.
authors.forename: Tae Yong
authors.initials: TY
authors.lastname: Jun
keywords: Fournier gangrene; Necrotizing fasciitis; Soft tissue infection