[Biochemicals markers of risk for mortality in necrotizing fasciitis]

To identify if anemia, hypoalbuminemia, hypocalcemia, elevated values of creatinephosphokinase and hypoprothrombinemia are risk for mortality in necrotizing fasciitis according to the anatomical site and affected surface.

A case and controls study was done in one prospective cohort. We documented age, associated factors, infection location, affected corporal surface, laboratory data, germs, treatment and evolution. We defined two groups of patients: deceased and survivors and we stratified in 6 subgroups according to the anatomical site.

394 patients were included; 252 men and 142 women, age average 52.8 years. We stratified in subgroups: extremities (n = 113), masculine genital (n = 103), trunk and abdomen (n = 64), neck and thorax (n = 44), feminine genital, perineum, groin (n = 42), sacrum and buttocks (n = 28). Hypoalbuminemia (OR = 3.8, CI = 1.5-9.5, p < 0.000), hypocalcemia (OR = 5.7, CI = 3.2-9.9, p= 0.030), elevated creatinephosphokinase (OR = 1.5, CI 1.0-2.4, p < 0.000) and anemia (OR = 4.4, CI 2.8-6.9, p < 0.000), were associated to mortality. Logistic regression analysis found that albumin (OR = 3.8, CI = 1.5-8.9), prothrombin (OR = 6.6, CI = 3.6-19.5) and evolution time (OR 5.2, IC = 1.2-8.3) showed statistically significant relationship with mortality (p < 0.05).

Hypocalcemia, hypoprothrombinemia, anemia, elevated creatinephosphokinase and evolution time could be risk markers for mortality.