Related Experiment Videos
Mortality in patients with necrotizing fasciitis
Alexander Golger1, Shim Ching, Charlie H Goldsmith
1Hamilton, Ontario, Canada From the Division of Plastic Surgery, Department of Surgery and Departments of Pathology and Molecular Medicine and Clinical Epidemiology and Biostatistics, McMaster University.
Plastic and Reconstructive Surgery
|April 19, 2007
Summary
Necrotizing fasciitis outcomes are poorly understood. Advanced age, streptococcal toxic shock syndrome, and immunocompromised status independently predict mortality, enabling a new risk assessment tool.
Area of Science:
- Infectious Diseases
- Surgical Critical Care
- Public Health
Background:
- Prognostic factors for necrotizing fasciitis (NF) outcomes are not well-defined.
- Understanding mortality and morbidity predictors is crucial for patient management.
- Developing a method to estimate mortality probability in NF patients is needed.
Purpose of the Study:
- To analyze variables impacting mortality and morbidity in necrotizing fasciitis patients.
- To develop a simple method for estimating the probability of mortality in NF.
Main Methods:
- Retrospective review of 99 necrotizing fasciitis patients across three Ontario tertiary care hospitals (1994-2001).
- Collated and analyzed demographic, comorbidity, and disease-specific data.
- Utilized logistic regression to identify independent predictors of mortality.
Main Results:
- Overall mortality rate was 20%; 16 patients experienced amputation or organ loss.
- Independent predictors of mortality included advanced age (OR 1.04), streptococcal toxic shock syndrome (OR 10.54), and immunocompromised status (OR 3.97).
- These factors were used to create a formula for predicting mortality probability.
Conclusions:
- Age, streptococcal toxic shock syndrome, and immune status significantly determine mortality risk in necrotizing fasciitis.
- These factors allow for early prediction of death probability post-admission.
- Objective data can inform clinical decisions and patient-clinician communication.
Related Concept Videos
01:16Necrosis
Necrosis is considered as an “accidental” or unexpected form of cell death that ends in cell lysis. The first noticeable mention of “necrosis” was in 1859 when Rudolf Virchow used this term to describe advanced tissue breakdown in his compilation titled “Cell Pathology”.
Morphological Manifestations of Necrosis
Necrotic cells show different types of morphological appearance depending on the type of tissue and infection. In coagulative necrosis, cells become anucleated and die, but their...
Morphological Manifestations of Necrosis
Necrotic cells show different types of morphological appearance depending on the type of tissue and infection. In coagulative necrosis, cells become anucleated and die, but their...
01:16Cellular Injury IV: Necrosis
Necrosis is a form of irreversible cell death caused by severe injury such as ischemia, toxins, or trauma. Unlike programmed cell death, it is an uncontrolled, pathological process that typically provokes inflammation in surrounding tissues.Pathophysiologic ChangesNecrosis begins when cells sustain critical damage, leading to swelling of organelles, particularly mitochondria, and rapid ATP depletion. As energy levels decline, membrane ion pumps fail, leading to calcium influx and eventually,...
01:22Burn Injuries
Burn injuries occur when the skin and underlying tissues are damaged due to exposure to heat, electricity, chemicals, radiation, or friction. They can vary in severity, from minor superficial burns to severe deep burns that can be life-threatening.
The damage results in the death of skin cells, which can lead to a massive loss of fluid. Dehydration, electrolyte imbalance, and renal and circulatory failure follow, which can be fatal. Burn patients are treated with intravenous fluids to offset...
The damage results in the death of skin cells, which can lead to a massive loss of fluid. Dehydration, electrolyte imbalance, and renal and circulatory failure follow, which can be fatal. Burn patients are treated with intravenous fluids to offset...
01:25Inhalation Anthrax
Anthrax is a zoonotic disease caused by Bacillus anthracis, a Gram-positive, spore-forming bacterium. It primarily affects herbivorous animals but can be transmitted to humans through skin contact, ingestion, or inhalation of spores.Cutaneous anthrax, the most common form, typically results from direct contact with bacterial spores through skin abrasions and is generally less severe. Gastrointestinal anthrax results from eating undercooked or contaminated meat. It affects the mouth, throat, or...
01:26Rocky Mountain Spotted Fever
Rocky Mountain Spotted Fever (RMSF) is a severe tick-borne illness caused by Rickettsia rickettsii, a Gram-negative, coccobacillary bacterium. This pathogen is an obligate intracellular parasite, requiring a host cell for replication. Transmission occurs through the bite of an infected tick. In the United States, the most important vectors are Dermacentor variabilis (American dog tick) and Dermacentor andersoni (Rocky Mountain wood tick), though other tick species may also serve as vectors.