Mustapa, Noor Shazlini
(2016)
Retrospective study of the outcomes of necrotizing fasciitis in intensive care unit, Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan.
Masters thesis, Universiti Sains Malaysia.
Abstract
Background: Necrotizing fasciitis is a rapidly progressive soft tissue infection involving
deep fascia which carries relatively high mortality rate worldwide. The aim of this study
is to determine the mortality rate in our local general hospital and to investigate the factors
that determine the primary outcome (mortality) of the necrotizing fasciitis patients treated
in Intensive Care Unit.
Methods: This is retrospective cross sectional study involved 71 patients admitted to
intensive care unit (ICU) HRPZ II from January 2012 to December 2015. Patients were
analyzed for presence of co-morbidities, Acute Physiology and Chronic Health
Evaluation (APACHE II score), factors important in pathogenesis and treatment, and
mortality.
Results: The overall mortality was 22/71(31%). The mean APACHE II score was 19.2
(SD=6.57) and the median time to operation was 50 hours (IQR=70.0). Factors directly
contributing towards mortality were higher APACHE II score (adjusted OR 1.41, 95%CI:
1.20, 1.66, P< 0.001) and an increase in time to surgical debridement (adjusted OR 1.03,
95%CI: 1.01, 1.05, P=0.003)
Conclusion: Early surgical debridement was crucial in the treating the necrotizing
fasciitis. High APACHE 11 score during admission was associated with increase
mortality.
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