Epidemiology and Infection

Short Report

Bacterial infections

The epidemiology of necrotizing fasciitis including factors associated with death and amputation

M. S. DWORKINa1a2 c1, M. D. WESTERCAMPa1, L. PARKa2 and A. McINTYREa2

a1 Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, IL, USA

a2 Illinois Department of Public Health, Division of Infectious Diseases, Chicago, IL, USA

SUMMARY

The high morbidity and mortality of necrotizing fasciitis (NF) supports the need for epidemiological studies to characterize the disease and identify patient factors associated with adverse outcomes. A multi-site medical record review of patients diagnosed with NF was performed (n=80, mortality 15%). Variables collected were hypothesized to have association with adverse outcomes from NF, and multivariable analysis was used to detect any such association in this population. Select factors associated with mortality included evidence of underlying conditions (P=0·002), advanced age (P=0·04), young age (P=0·03), and evidence of sepsis (P=0·006). Select factors associated with amputation included diabetes mellitus (P=0·006), evidence of underlying conditions (P=0·03), and cutaneous gangrene noted on admission (P=0·006). These findings demonstrate the important association of NF and extremes of age with mortality and morbidity and support the value of early suspicion with prompt diagnosis and treatment in order to prevent adverse outcomes since the associated risk factors are not immediately modifiable.

(Accepted March 06 2009)

(Online publication April 07 2009)

Correspondence:

c1 Author for correspondence: Dr M. S. Dworkin, UIC School of Public Health (MC 923), 1603 W. Taylor Street, Chicago, IL 60612-4394, USA. (Email: mdworkin@uic.edu)

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