Predicting Morbidity and Mortality in Patients with Lower Extremity Necrotizing Fasciitis
Necrotizing fasciitis (NF) is a rare but limb- and life-threatening soft-tissue infection. It is among the most challenging surgical infections faced by surgeons, and is often accompanied by severe systemic toxicity. The aim of this study was to evaluate the predictive power of serum lactate and cre...
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| Veröffentlicht in: | Şişli Etfal Hastanesi tıp bülteni 2019-01, Vol.53 (1), p.27-32 |
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| container_title | Şişli Etfal Hastanesi tıp bülteni |
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| creator | İrmak, Fatih Karsidag, Semra |
| description | Necrotizing fasciitis (NF) is a rare but limb- and life-threatening soft-tissue infection. It is among the most challenging surgical infections faced by surgeons, and is often accompanied by severe systemic toxicity. The aim of this study was to evaluate the predictive power of serum lactate and creatinine levels for mortality and morbidity in lower extremity NF.
A retrospective cohort analysis of 87 patients with lower extremity NF was performed to evaluate the management techniques and the amputation and survival rates according to serum lactate and creatinine levels as well as the time between the onset of symptoms and surgery.
The mean time between the onset of symptoms and surgery was 3.7 days. As the time between the onset of symptoms and surgery increased, the rate of amputation and mortality significantly increased (p |
| doi_str_mv | 10.14744/SEMB.2019.57778 |
| format | Article |
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A retrospective cohort analysis of 87 patients with lower extremity NF was performed to evaluate the management techniques and the amputation and survival rates according to serum lactate and creatinine levels as well as the time between the onset of symptoms and surgery.
The mean time between the onset of symptoms and surgery was 3.7 days. As the time between the onset of symptoms and surgery increased, the rate of amputation and mortality significantly increased (p<0.001). In all, 66% of the mortality in the group was seen among the 12 patients who had a serum creatinine level greater than 2 mg/dL at the time of presentation. In 12 of 14 patients (85.7%) who underwent amputation/disarticulation, the mean serum lactate level was 5.7 mmol/L (range: 5.1-8.7 mmol/L), and the mean serum creatinine level was 1.92 mg/dL (range: 1.4 to.3.3 mg/dL). The high levels of serum creatinine and lactate were found to be statistically significant in terms of predicting mortality and amputation (p<0.001).
Based on the results of this study, it was determined that risk factors for mortality include age, late presentation, increased serum creatinine and lactate levels, and that these factors can predict the rate of death from NF at the time of presentation.</description><identifier>ISSN: 1302-7123</identifier><identifier>EISSN: 1308-5123</identifier><identifier>DOI: 10.14744/SEMB.2019.57778</identifier><identifier>PMID: 33536822</identifier><language>eng</language><publisher>Turkey: Kare Publishing</publisher><subject>Amputation ; Health risk assessment ; Mortality ; Necrotizing fasciitis ; Original Research ; Surgery</subject><ispartof>Şişli Etfal Hastanesi tıp bülteni, 2019-01, Vol.53 (1), p.27-32</ispartof><rights>Copyright: © 2019 by The Medical Bulletin of Sisli Etfal Hospital.</rights><rights>Copyright Yerkure Tanitim ve Yayincilik Hizmetleri A.S. 2019</rights><rights>Copyright: © 2019 by The Medical Bulletin of Sisli Etfal Hospital 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c354t-2e86d614494f43949d45599c38ae5086ff0b1bd4a714fa04a65372276bf509883</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7847728/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7847728/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33536822$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>İrmak, Fatih</creatorcontrib><creatorcontrib>Karsidag, Semra</creatorcontrib><title>Predicting Morbidity and Mortality in Patients with Lower Extremity Necrotizing Fasciitis</title><title>Şişli Etfal Hastanesi tıp bülteni</title><addtitle>Sisli Etfal Hastan Tip Bul</addtitle><description>Necrotizing fasciitis (NF) is a rare but limb- and life-threatening soft-tissue infection. It is among the most challenging surgical infections faced by surgeons, and is often accompanied by severe systemic toxicity. The aim of this study was to evaluate the predictive power of serum lactate and creatinine levels for mortality and morbidity in lower extremity NF.
A retrospective cohort analysis of 87 patients with lower extremity NF was performed to evaluate the management techniques and the amputation and survival rates according to serum lactate and creatinine levels as well as the time between the onset of symptoms and surgery.
The mean time between the onset of symptoms and surgery was 3.7 days. As the time between the onset of symptoms and surgery increased, the rate of amputation and mortality significantly increased (p<0.001). In all, 66% of the mortality in the group was seen among the 12 patients who had a serum creatinine level greater than 2 mg/dL at the time of presentation. In 12 of 14 patients (85.7%) who underwent amputation/disarticulation, the mean serum lactate level was 5.7 mmol/L (range: 5.1-8.7 mmol/L), and the mean serum creatinine level was 1.92 mg/dL (range: 1.4 to.3.3 mg/dL). The high levels of serum creatinine and lactate were found to be statistically significant in terms of predicting mortality and amputation (p<0.001).
Based on the results of this study, it was determined that risk factors for mortality include age, late presentation, increased serum creatinine and lactate levels, and that these factors can predict the rate of death from NF at the time of presentation.</description><subject>Amputation</subject><subject>Health risk assessment</subject><subject>Mortality</subject><subject>Necrotizing fasciitis</subject><subject>Original Research</subject><subject>Surgery</subject><issn>1302-7123</issn><issn>1308-5123</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkclLxDAUxoMoKurdkxS8eOmY5WXpRVAZFxgXUA-eQtqmGum0mmTc_nrTcUHNJe-R7318Lz-ENgkeEZAAu1fjs4MRxaQYcSmlWkCrhGGVc0LZ4rymuUz1CtoI4QGnIwiVoJbRCmOcCUXpKrq99LZ2VXTdXXbW-9LVLr5lpquHLpp26FyXXZrobBdD9uLifTbpX6zPxq_R2-kgOLeV76N7H0yOTKiciy6so6XGtMFufN1r6OZofH14kk8ujk8P9yd5xTjEnFolakEACmiAFVDUwHlRVEwZy7ESTYNLUtZgJIHGYDCCM0mpFGXDcaEUW0N7n76Ps3Jq6yrF9KbVj95NjX_TvXH670vn7vVd_6ylAinpYLDzZeD7p5kNUU9dqGzbms72s6ApKAFCFJwl6fY_6UM_811aT1OKBaYpGEkq_KlKvxKCt81PGIL1HJ0e0OkBnZ6jSyNbv5f4GfgGxT4ACVKUbA</recordid><startdate>20190101</startdate><enddate>20190101</enddate><creator>İrmak, Fatih</creator><creator>Karsidag, Semra</creator><general>Kare Publishing</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>EDSIH</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20190101</creationdate><title>Predicting Morbidity and Mortality in Patients with Lower Extremity Necrotizing Fasciitis</title><author>İrmak, Fatih ; Karsidag, Semra</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c354t-2e86d614494f43949d45599c38ae5086ff0b1bd4a714fa04a65372276bf509883</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Amputation</topic><topic>Health risk assessment</topic><topic>Mortality</topic><topic>Necrotizing fasciitis</topic><topic>Original Research</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>İrmak, Fatih</creatorcontrib><creatorcontrib>Karsidag, Semra</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</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 Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Turkey 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>Publicly Available Content Database</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>PubMed Central (Full Participant titles)</collection><jtitle>Şişli Etfal Hastanesi tıp bülteni</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>İrmak, Fatih</au><au>Karsidag, Semra</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predicting Morbidity and Mortality in Patients with Lower Extremity Necrotizing Fasciitis</atitle><jtitle>Şişli Etfal Hastanesi tıp bülteni</jtitle><addtitle>Sisli Etfal Hastan Tip Bul</addtitle><date>2019-01-01</date><risdate>2019</risdate><volume>53</volume><issue>1</issue><spage>27</spage><epage>32</epage><pages>27-32</pages><issn>1302-7123</issn><eissn>1308-5123</eissn><abstract>Necrotizing fasciitis (NF) is a rare but limb- and life-threatening soft-tissue infection. It is among the most challenging surgical infections faced by surgeons, and is often accompanied by severe systemic toxicity. The aim of this study was to evaluate the predictive power of serum lactate and creatinine levels for mortality and morbidity in lower extremity NF.
A retrospective cohort analysis of 87 patients with lower extremity NF was performed to evaluate the management techniques and the amputation and survival rates according to serum lactate and creatinine levels as well as the time between the onset of symptoms and surgery.
The mean time between the onset of symptoms and surgery was 3.7 days. As the time between the onset of symptoms and surgery increased, the rate of amputation and mortality significantly increased (p<0.001). In all, 66% of the mortality in the group was seen among the 12 patients who had a serum creatinine level greater than 2 mg/dL at the time of presentation. In 12 of 14 patients (85.7%) who underwent amputation/disarticulation, the mean serum lactate level was 5.7 mmol/L (range: 5.1-8.7 mmol/L), and the mean serum creatinine level was 1.92 mg/dL (range: 1.4 to.3.3 mg/dL). The high levels of serum creatinine and lactate were found to be statistically significant in terms of predicting mortality and amputation (p<0.001).
Based on the results of this study, it was determined that risk factors for mortality include age, late presentation, increased serum creatinine and lactate levels, and that these factors can predict the rate of death from NF at the time of presentation.</abstract><cop>Turkey</cop><pub>Kare Publishing</pub><pmid>33536822</pmid><doi>10.14744/SEMB.2019.57778</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; PubMed Central |
| subjects | Amputation Health risk assessment Mortality Necrotizing fasciitis Original Research Surgery |
| title | Predicting Morbidity and Mortality in Patients with Lower Extremity Necrotizing Fasciitis |
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