Demographic Variations in Amputation Rates for Upper-Extremity Necrotizing Fasciitis.

Area of Science:

• Surgical Outcomes
• Health Disparities
• Infectious Disease

Background:

• Necrotizing fasciitis of the upper extremity is a severe condition with significant morbidity.
• Surgical outcomes are influenced by presentation delay and comorbidities.
• Healthcare disparities disproportionately affect underrepresented populations in surgery.

Purpose of the Study:

• To investigate if race or ethnicity impacts outcomes in patients with upper extremity necrotizing fasciitis.
• To assess population-wide data on surgical results for this condition.
• To identify potential disparities in care.

Main Methods:

• Utilized the TriNetX database for patients with necrotizing fasciitis undergoing upper extremity surgery (2010-2024).
• Evaluated amputation incidence and 6-month mortality, stratified by race and ethnicity.
• Employed logistic regression to control for confounding factors like age, sex, comorbidities, and lab values.

Main Results:

• Identified 1,396 patients undergoing upper extremity procedures for necrotizing fasciitis.
• Minority patients showed significantly higher odds of amputation (OR 1.5) versus non-Hispanic White patients.
• Amputation disparities persisted in Hispanic and Asian/Pacific Islander groups.

Conclusions:

• Underrepresented minority patients with necrotizing fasciitis experience a 50% greater frequency of amputations compared to non-Hispanic White patients.
• This study underscores significant racial and ethnic disparities in surgical outcomes for upper extremity necrotizing fasciitis.
• Addressing these disparities is crucial for equitable patient care.