Necrotizing soft tissue infections after injection therapy: Higher mortality and worse outcome compared to other entry mechanisms - 03/08/15
, Sebastian Torka , Matthias Militz , Volker Bühren , Sven Hungerer Summary |
Objectives |
Necrotizing Soft Tissue Infections represent a rare entity of infection associated with a high mortality. The aim of this retrospective study was to analyze patients with an iatrogenic etiology of injection or infiltration to compare the outcome with other etiologies.
Methods |
The study group consisted of 21 patients treated with a Necrotizing Fasciitis caused by injection or infiltration. Risk factors and outcome were compared to 134 patients with a Necrotizing Fasciitis caused by other entry mechanisms.
Results |
Overall mortality in our study group was 14 of 21 (67%) with an amputation rate of 11 of 15 (73%) if an extremity was involved. The survival rate was significantly worse after injection or infiltration (p < 0.001) as was the amputation rate (p = 0.013), the percentage of patients requiring intensive care (100% vs. 83%, p = 0.038) and vasopressors (81% vs. 54%, p = 0.02). Injection or infiltration therapy proved to be the strongest prognostic factor (p = 0.003) besides the known risk factors obesity (0.007) and renal insufficiency (0.025).
Conclusions |
Our results demonstrate that patients with a Necrotizing Soft Tissue Infection after injection or infiltration therapy have a significantly worse prognosis.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Necrotizing Soft Tissue Infections represent a serious infection with a high mortality. |
• | Survival rates are significantly lower if the entry route is an injection or an infiltration. |
• | Amputation rates are higher if the infection is caused by injection or infiltration therapy. |
• | Injection or infiltration therapy is an independent prognostic factor of a higher mortality. |
Keywords : Necrotizing soft tissue infection, Necrotizing fasciitis, Injection therapy
Plan
Vol 71 - N° 3
P. 312-316 - septembre 2015 Retour au numéro
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