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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Veröffentlicht in:Intensive care medicine 2012-07, Vol.38 (7), p.1143-1151
Hauptverfasser: Soh, Chai R., Pietrobon, Ricardo, Freiberger, John J., Chew, Sophia T., Rajgor, Dimple, Gandhi, Mihir, Shah, Jatin, Moon, Richard E.
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container_end_page 1151
container_issue 7
container_start_page 1143
container_title Intensive care medicine
container_volume 38
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
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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  &lt; 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 &amp; numerical data ; Hospitals ; Humans ; Hyperbaric Oxygenation ; Infection ; Infections ; Inflation (Finance) ; Intensive ; Intensive care medicine ; Length of stay ; Male ; Medical research ; Medical sciences ; Medicine ; Medicine &amp; 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&amp;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  &lt; 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 &amp; 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 &amp; 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 &amp; 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 &amp; 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 &amp; Allied Health Database</collection><collection>Health &amp; 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 &amp; Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health &amp; Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health &amp; 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  &lt; 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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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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