Hyperbaric oxygen therapy in necrotising soft tissue infections: a study of patients in the United States Nationwide Inpatient Sample
Purpose Necrotising soft tissue infection (NSTI) is a deadly disease associated with a significant risk of mortality and long-term disability from limb and tissue loss. The aim of this study was to determine the effect of hyperbaric oxygen (HBO 2 ) therapy on mortality, complication rate, discharge...
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creator | Soh, Chai R. Pietrobon, Ricardo Freiberger, John J. Chew, Sophia T. Rajgor, Dimple Gandhi, Mihir Shah, Jatin Moon, Richard E. |
description | Purpose
Necrotising soft tissue infection (NSTI) is a deadly disease associated with a significant risk of mortality and long-term disability from limb and tissue loss. The aim of this study was to determine the effect of hyperbaric oxygen (HBO
2
) therapy on mortality, complication rate, discharge status/location, hospital length of stay and inflation-adjusted hospitalisation cost in patients with NSTI.
Methods
This was a retrospective study of 45,913 patients in the Nationwide Inpatient Sample (NIS) from 1988 to 2009.
Results
A total of 405 patients received HBO
2
therapy. The patients with NSTI who received HBO
2
therapy had a lower mortality (4.5 vs. 9.4 %,
p
= 0.001). After adjusting for predictors and confounders, patients who received HBO
2
therapy had a statistically significantly lower risk of dying (odds ratio (OR) 0.49, 95 % confidence interval (CI) 0.29–0.83), higher hospitalisation cost (US$52,205 vs. US$45,464,
p
= 0.02) and longer length of stay (LOS) (14.3 days vs. 10.7 days,
p
|
doi_str_mv | 10.1007/s00134-012-2558-4 |
format | Article |
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Necrotising soft tissue infection (NSTI) is a deadly disease associated with a significant risk of mortality and long-term disability from limb and tissue loss. The aim of this study was to determine the effect of hyperbaric oxygen (HBO
2
) therapy on mortality, complication rate, discharge status/location, hospital length of stay and inflation-adjusted hospitalisation cost in patients with NSTI.
Methods
This was a retrospective study of 45,913 patients in the Nationwide Inpatient Sample (NIS) from 1988 to 2009.
Results
A total of 405 patients received HBO
2
therapy. The patients with NSTI who received HBO
2
therapy had a lower mortality (4.5 vs. 9.4 %,
p
= 0.001). After adjusting for predictors and confounders, patients who received HBO
2
therapy had a statistically significantly lower risk of dying (odds ratio (OR) 0.49, 95 % confidence interval (CI) 0.29–0.83), higher hospitalisation cost (US$52,205 vs. US$45,464,
p
= 0.02) and longer length of stay (LOS) (14.3 days vs. 10.7 days,
p
< 0.001).
Conclusions
This retrospective analysis of HBO
2
therapy in NSTI showed that despite the higher hospitalisation cost and longer length of stay, the statistically significant reduction in mortality supports the use of HBO
2
therapy in NSTI.</description><identifier>ISSN: 0342-4642</identifier><identifier>EISSN: 1432-1238</identifier><identifier>DOI: 10.1007/s00134-012-2558-4</identifier><identifier>PMID: 22527074</identifier><identifier>CODEN: ICMED9</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Amputation ; Analysis ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Anesthesiology ; Biological and medical sciences ; Cardiac arrest ; Care and treatment ; Comorbidity ; Critical Care Medicine ; Diseases of the respiratory system ; Emergency Medicine ; Female ; Health aspects ; Hospital Costs ; Hospitalization ; Hospitalization - economics ; Hospitalization - statistics & numerical data ; Hospitals ; Humans ; Hyperbaric Oxygenation ; Infection ; Infections ; Inflation (Finance) ; Intensive ; Intensive care medicine ; Length of stay ; Male ; Medical research ; Medical sciences ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Middle Aged ; Mortality ; Necrosis ; Original ; Oxygen therapy ; Pain Medicine ; Pediatrics ; Pneumology/Respiratory System ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Retrospective Studies ; Sepsis ; Serbia ; Singapore ; Soft Tissue Infections - mortality ; Soft Tissue Infections - pathology ; Soft Tissue Infections - therapy ; Survival Analysis ; Treatment Outcome ; United States - epidemiology</subject><ispartof>Intensive care medicine, 2012-07, Vol.38 (7), p.1143-1151</ispartof><rights>Copyright jointly held by Springer and ESICM 2012</rights><rights>2015 INIST-CNRS</rights><rights>COPYRIGHT 2012 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c529t-176a33dce209f2b9d42ab3897cecc6c52076a3b55137ad4fdc2aedfde3460e63</citedby><cites>FETCH-LOGICAL-c529t-176a33dce209f2b9d42ab3897cecc6c52076a3b55137ad4fdc2aedfde3460e63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00134-012-2558-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00134-012-2558-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26037801$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22527074$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Soh, Chai R.</creatorcontrib><creatorcontrib>Pietrobon, Ricardo</creatorcontrib><creatorcontrib>Freiberger, John J.</creatorcontrib><creatorcontrib>Chew, Sophia T.</creatorcontrib><creatorcontrib>Rajgor, Dimple</creatorcontrib><creatorcontrib>Gandhi, Mihir</creatorcontrib><creatorcontrib>Shah, Jatin</creatorcontrib><creatorcontrib>Moon, Richard E.</creatorcontrib><title>Hyperbaric oxygen therapy in necrotising soft tissue infections: a study of patients in the United States Nationwide Inpatient Sample</title><title>Intensive care medicine</title><addtitle>Intensive Care Med</addtitle><addtitle>Intensive Care Med</addtitle><description>Purpose
Necrotising soft tissue infection (NSTI) is a deadly disease associated with a significant risk of mortality and long-term disability from limb and tissue loss. The aim of this study was to determine the effect of hyperbaric oxygen (HBO
2
) therapy on mortality, complication rate, discharge status/location, hospital length of stay and inflation-adjusted hospitalisation cost in patients with NSTI.
Methods
This was a retrospective study of 45,913 patients in the Nationwide Inpatient Sample (NIS) from 1988 to 2009.
Results
A total of 405 patients received HBO
2
therapy. The patients with NSTI who received HBO
2
therapy had a lower mortality (4.5 vs. 9.4 %,
p
= 0.001). After adjusting for predictors and confounders, patients who received HBO
2
therapy had a statistically significantly lower risk of dying (odds ratio (OR) 0.49, 95 % confidence interval (CI) 0.29–0.83), higher hospitalisation cost (US$52,205 vs. US$45,464,
p
= 0.02) and longer length of stay (LOS) (14.3 days vs. 10.7 days,
p
< 0.001).
Conclusions
This retrospective analysis of HBO
2
therapy in NSTI showed that despite the higher hospitalisation cost and longer length of stay, the statistically significant reduction in mortality supports the use of HBO
2
therapy in NSTI.</description><subject>Amputation</subject><subject>Analysis</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Anesthesiology</subject><subject>Biological and medical sciences</subject><subject>Cardiac arrest</subject><subject>Care and treatment</subject><subject>Comorbidity</subject><subject>Critical Care Medicine</subject><subject>Diseases of the respiratory system</subject><subject>Emergency Medicine</subject><subject>Female</subject><subject>Health aspects</subject><subject>Hospital Costs</subject><subject>Hospitalization</subject><subject>Hospitalization - economics</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hyperbaric Oxygenation</subject><subject>Infection</subject><subject>Infections</subject><subject>Inflation (Finance)</subject><subject>Intensive</subject><subject>Intensive care medicine</subject><subject>Length of stay</subject><subject>Male</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Necrosis</subject><subject>Original</subject><subject>Oxygen therapy</subject><subject>Pain Medicine</subject><subject>Pediatrics</subject><subject>Pneumology/Respiratory System</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Retrospective Studies</subject><subject>Sepsis</subject><subject>Serbia</subject><subject>Singapore</subject><subject>Soft Tissue Infections - mortality</subject><subject>Soft Tissue Infections - pathology</subject><subject>Soft Tissue Infections - therapy</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><subject>United States - epidemiology</subject><issn>0342-4642</issn><issn>1432-1238</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkd9qFTEQxoMo9lh9AG8kIAVv1iaT7D_vSlFbKPai9Tpkk9ljyp7smmTRfYC-t1nP0YogSC4SmN_3zUw-Ql5y9pYzVp9GxriQBeNQQFk2hXxENlwKKDiI5jHZMCGhkJWEI_IsxrtM11XJn5IjgBJqVssNub9YJgydDs7Q8fuyRU_TFwx6Wqjz1KMJY3LR-S2NY59ofscZc6lHk9zo4zuqaUyzXejY00knhz7FVZpd6GfvElp6k3TCSD_pVfHNWaSX_oDSG72bBnxOnvR6iPjicB-T2w_vb88viqvrj5fnZ1eFKaFNRR5fC2ENAmt76ForQXeiaWuDxlSZYSvQlSUXtbaytwY02t6ikBXDShyTN3vbKYxfZ4xJ7Vw0OAza4zhHxRk0DKoW4H9Q1kA-PKOv_0Lvxjn4vMdPSrZlnvCB2uoBVf7AMQVtVlN1VoMUvMyZZIrvqfzvMQbs1RTcToclW6k1c7XPXOXM1Zq5klnz6tB_7nZofyt-hZyBkwOgo9FDH7Q3Lj5wFRN1w9ZFYM_FXPJbDH8u8q_uPwArb8Pq</recordid><startdate>20120701</startdate><enddate>20120701</enddate><creator>Soh, Chai R.</creator><creator>Pietrobon, Ricardo</creator><creator>Freiberger, John J.</creator><creator>Chew, Sophia T.</creator><creator>Rajgor, Dimple</creator><creator>Gandhi, Mihir</creator><creator>Shah, Jatin</creator><creator>Moon, Richard E.</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope></search><sort><creationdate>20120701</creationdate><title>Hyperbaric oxygen therapy in necrotising soft tissue infections: a study of patients in the United States Nationwide Inpatient Sample</title><author>Soh, Chai R. ; Pietrobon, Ricardo ; Freiberger, John J. ; Chew, Sophia T. ; Rajgor, Dimple ; Gandhi, Mihir ; Shah, Jatin ; Moon, Richard E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c529t-176a33dce209f2b9d42ab3897cecc6c52076a3b55137ad4fdc2aedfde3460e63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Amputation</topic><topic>Analysis</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Anesthesiology</topic><topic>Biological and medical sciences</topic><topic>Cardiac arrest</topic><topic>Care and treatment</topic><topic>Comorbidity</topic><topic>Critical Care Medicine</topic><topic>Diseases of the respiratory system</topic><topic>Emergency Medicine</topic><topic>Female</topic><topic>Health aspects</topic><topic>Hospital Costs</topic><topic>Hospitalization</topic><topic>Hospitalization - economics</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hyperbaric Oxygenation</topic><topic>Infection</topic><topic>Infections</topic><topic>Inflation (Finance)</topic><topic>Intensive</topic><topic>Intensive care medicine</topic><topic>Length of stay</topic><topic>Male</topic><topic>Medical research</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Necrosis</topic><topic>Original</topic><topic>Oxygen therapy</topic><topic>Pain Medicine</topic><topic>Pediatrics</topic><topic>Pneumology/Respiratory System</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Retrospective Studies</topic><topic>Sepsis</topic><topic>Serbia</topic><topic>Singapore</topic><topic>Soft Tissue Infections - mortality</topic><topic>Soft Tissue Infections - pathology</topic><topic>Soft Tissue Infections - therapy</topic><topic>Survival Analysis</topic><topic>Treatment Outcome</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Soh, Chai R.</creatorcontrib><creatorcontrib>Pietrobon, Ricardo</creatorcontrib><creatorcontrib>Freiberger, John J.</creatorcontrib><creatorcontrib>Chew, Sophia T.</creatorcontrib><creatorcontrib>Rajgor, Dimple</creatorcontrib><creatorcontrib>Gandhi, Mihir</creatorcontrib><creatorcontrib>Shah, Jatin</creatorcontrib><creatorcontrib>Moon, Richard E.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Intensive care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Soh, Chai R.</au><au>Pietrobon, Ricardo</au><au>Freiberger, John J.</au><au>Chew, Sophia T.</au><au>Rajgor, Dimple</au><au>Gandhi, Mihir</au><au>Shah, Jatin</au><au>Moon, Richard E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hyperbaric oxygen therapy in necrotising soft tissue infections: a study of patients in the United States Nationwide Inpatient Sample</atitle><jtitle>Intensive care medicine</jtitle><stitle>Intensive Care Med</stitle><addtitle>Intensive Care Med</addtitle><date>2012-07-01</date><risdate>2012</risdate><volume>38</volume><issue>7</issue><spage>1143</spage><epage>1151</epage><pages>1143-1151</pages><issn>0342-4642</issn><eissn>1432-1238</eissn><coden>ICMED9</coden><abstract>Purpose
Necrotising soft tissue infection (NSTI) is a deadly disease associated with a significant risk of mortality and long-term disability from limb and tissue loss. The aim of this study was to determine the effect of hyperbaric oxygen (HBO
2
) therapy on mortality, complication rate, discharge status/location, hospital length of stay and inflation-adjusted hospitalisation cost in patients with NSTI.
Methods
This was a retrospective study of 45,913 patients in the Nationwide Inpatient Sample (NIS) from 1988 to 2009.
Results
A total of 405 patients received HBO
2
therapy. The patients with NSTI who received HBO
2
therapy had a lower mortality (4.5 vs. 9.4 %,
p
= 0.001). After adjusting for predictors and confounders, patients who received HBO
2
therapy had a statistically significantly lower risk of dying (odds ratio (OR) 0.49, 95 % confidence interval (CI) 0.29–0.83), higher hospitalisation cost (US$52,205 vs. US$45,464,
p
= 0.02) and longer length of stay (LOS) (14.3 days vs. 10.7 days,
p
< 0.001).
Conclusions
This retrospective analysis of HBO
2
therapy in NSTI showed that despite the higher hospitalisation cost and longer length of stay, the statistically significant reduction in mortality supports the use of HBO
2
therapy in NSTI.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>22527074</pmid><doi>10.1007/s00134-012-2558-4</doi><tpages>9</tpages></addata></record> |
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source | MEDLINE; Springer Nature - Complete Springer Journals |
subjects | Amputation Analysis Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Anesthesiology Biological and medical sciences Cardiac arrest Care and treatment Comorbidity Critical Care Medicine Diseases of the respiratory system Emergency Medicine Female Health aspects Hospital Costs Hospitalization Hospitalization - economics Hospitalization - statistics & numerical data Hospitals Humans Hyperbaric Oxygenation Infection Infections Inflation (Finance) Intensive Intensive care medicine Length of stay Male Medical research Medical sciences Medicine Medicine & Public Health Medicine, Experimental Middle Aged Mortality Necrosis Original Oxygen therapy Pain Medicine Pediatrics Pneumology/Respiratory System Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Retrospective Studies Sepsis Serbia Singapore Soft Tissue Infections - mortality Soft Tissue Infections - pathology Soft Tissue Infections - therapy Survival Analysis Treatment Outcome United States - epidemiology |
title | Hyperbaric oxygen therapy in necrotising soft tissue infections: a study of patients in the United States Nationwide Inpatient Sample |
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