Predicting mortality in necrotizing fasciitis: Retrospective evaluation of 69 cases

Necrotizing fasciitis (NF) is a severe and potentially life-threatening soft tissue infection characterized by rapid necrosis, primarily affecting the fascia and deep soft tissues. Despite its low incidence, NF poses significant challenges due to its aggressive nature and high mortality rates. This retrospective study aimed to assess clinical characteristics and prognostic factors influencing mortality rates among patients diagnosed with NF at a tertiary care facility.

Patients diagnosed with NF at the emergency department of tertiary care hospital in Turkiye between August 1, 2017, and July 31, 2023, were included in the study. Demographic data, clinical features, underlying factors, laboratory findings, and outcomes were reviewed.

A total of 69 adult patients were included in the study. Among cases, 51 survived (73.5%) and 18 died (26.5%). There were 43 males (62.3%) and 26 females (37.7%) with a mean age of 55.8±16.1 years. The most common symptoms were pain/tenderness (84.1%), erythema (75.4%), local swelling (72.5%), and crepitus (44.9%). Diabetes mellitus, lower systolic blood pressure, higher pulse rates, elevated white blood cell counts, and polymicrobial infections were associated with poor outcomes (p<0.001, p=0.020, p<0.001, p=0.016, and p<0.001, respectively).

NF is a rare surgical emergency. Early diagnosis, prompt intervention, and multidisciplinary management are crucial in mitigating NF's devastating consequences. Recognizing poor prognosis factors in patients can guide their management.