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Predisposing factors of necrotizing fasciitis with comparison to cellulitis in Taiwan: A nationwide population-based

Tom J Liu1, Hao-Chih Tai2, Kuo-Liong Chien3

  • 1Division of Plastic Surgery, Department of Surgery, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan.

Journal of the Formosan Medical Association = Taiwan Yi Zhi
|February 11, 2019
PubMed
Abstract

Insights

Necrotizing fasciitis (NF) is a severe infection. This study found that age and chronic diseases like diabetes increase NF risk in Taiwan, with chronic kidney disease and liver cirrhosis predicting mortality.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Public Health

Background:

  • Necrotizing fasciitis (NF) is a severe, rapidly progressing soft tissue infection requiring urgent surgical intervention.
  • Distinguishing NF from cellulitis in early stages is challenging, and population-based incidence data are scarce.
  • This study addresses the need for epidemiological data on NF in Taiwan.

Purpose of the Study:

  • To determine the annual incidence and in-hospital mortality rate of necrotizing fasciitis (NF) in Taiwan.
  • To identify risk factors for developing NF.
  • To identify predictors of in-hospital mortality for NF patients.

Main Methods:

  • A retrospective analysis of inpatient data from Taiwan's National Health Institute Research Database (2002-2011).
  • Inclusion criteria for the study group: patients diagnosed with NF who underwent surgery and were admitted to intensive care units.
  • Control group: age and gender-matched patients with cellulitis (1:4 ratio).

Main Results:

  • The study included 7391 NF patients, with an overall annual incidence of 3.26 hospitalizations per 100,000 person-years.
  • In-hospital mortality rate was 32.2%, increasing with age.
  • Key risk factors for NF included diabetes mellitus, alcoholism, and chronic kidney disease. Chronic kidney disease and liver cirrhosis predicted mortality.

Conclusions:

  • Age and chronic diseases are significant risk factors and prognostic indicators for NF in Taiwan.
  • Diabetes mellitus is associated with an increased risk of NF but does not worsen patient outcomes.
  • Findings highlight the importance of managing chronic conditions to mitigate NF risk and improve patient prognosis.
Keywords:
EpidemiologyMortalityNecrotizing fasciitisPredictors of mortalityPredisposing factors

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