Early surgical intervention and its impact on patients presenting with necrotizing soft tissue infections: A single academic center experience

George Hadeed, Judith Smith, Terence S Okeeffe, Narong Kulvatunyou, Julie Wynne, Bellal A Joseph, Randall S Friese, Thomas Wachtel, Peter M Rhee, Ayman El-Menyar, Rifat - Latifi

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objectives: Early diagnosis and emergent surgical debridement of necrotizing soft tissue infections (NSTIs) remains the cornerstone of care. We aimed to study the effect of early surgery on patients' outcomes and, in particular, on hospital length of stay (LOS) and Intensive Care Unit (ICU) LOS. Materials and Methods: Over a 6-year period (January 2003 through December 2008), we analyzed the records of patients with NSTIs. We divided patients into two groups based on the time of surgery (i.e., the interval from being diagnosed and surgical intervention): Early (2) test. To evaluate the clinical predictors of early diagnosis of NSTIs, we performed multivariate logistic regression analysis. Results: In the study population (n = 87; 62% males and 38% females), age, gender, wound locations, and comorbidities were comparable in the two groups. Except for higher proportion of crepitus, the clinical presentations showed no significant differences between the two groups. There were significantly shorter hospital LOS and ICU LOS in the early than late intervention group. The overall mortality rate in our study patients with NSTIs was 12.5%, but early intervention group had a mortality of 7.5%, but this did not reach statistical significance. Conclusions: Our findings show that early surgery, within the first 6 h after being diagnosed, improves in-hospital outcomes in patients with NSTIs.

Original languageEnglish (US)
Pages (from-to)22-27
Number of pages6
JournalJournal of Emergencies, Trauma and Shock
Volume9
Issue number1
DOIs
StatePublished - Jan 1 2016

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Soft Tissue Infections
Length of Stay
Intensive Care Units
Early Diagnosis
Mortality
Debridement
Comorbidity
Logistic Models
Regression Analysis
Wounds and Injuries
Population

Keywords

  • and early surgery
  • Early surgery
  • necrotizing fasciitis
  • necrotizing fasciitis
  • necrotizing soft tissue infections

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Early surgical intervention and its impact on patients presenting with necrotizing soft tissue infections : A single academic center experience. / Hadeed, George; Smith, Judith; Okeeffe, Terence S; Kulvatunyou, Narong; Wynne, Julie; Joseph, Bellal A; Friese, Randall S; Wachtel, Thomas; Rhee, Peter M; El-Menyar, Ayman; Latifi, Rifat -.

In: Journal of Emergencies, Trauma and Shock, Vol. 9, No. 1, 01.01.2016, p. 22-27.

Research output: Contribution to journalArticle

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