Necrotizing fasciitis and the midterm outcomes after survival.

Necrotizing fasciitis Short Form 36 Short Musculoskeletal Function Assessment amputation disability infection outcome parameters surgical debridement

Journal

SAGE open medicine
ISSN: 2050-3121
Titre abrégé: SAGE Open Med
Pays: England
ID NLM: 101624744

Informations de publication

Date de publication:
2019
Historique:
received: 27 09 2018
accepted: 15 03 2019
entrez: 7 5 2019
pubmed: 7 5 2019
medline: 7 5 2019
Statut: epublish

Résumé

Radical surgical intervention is necessary to save patients' lives in cases of necrotizing fasciitis. This leads to persistent disabilities and most likely to a deteriorated quality of life. The purpose of this study was to evaluate the midterm outcomes after survival of necrotizing fasciitis. A retrospective analysis of 69 patients, treated for necrotizing fasciitis between 2003 and 2012. The patients were identified using the International Classification of Diseases (10th Revision) code M 72.6. Of the 50 survivors, 22 patients completed the Short Form 36 and Short Musculoskeletal Function Assessment questionnaires as a postal survey. The follow-up averaged 59 months (range: 6-128 months). The average age at the time of necrotizing fasciitis was 60.0 years. The body mass index average was 29.7. The patients had a significantly decreased physical component summary score of 33.3 compared to a normative group (p < 0.001) (Short Form 36). They further showed a significantly decreased dysfunction and bother indices (Short Musculoskeletal Function Assessment) (p < 0.001). An increased age (⩾70 years) was associated with an inferior role emotional (p = 0.048) and physical functioning (p = 0.011) as well as social functioning (p = 0.038) (Short Form 36). The majority of patients (16, 72.7%) complained of pain at the final follow-up and 50% of patients required an assistive device on a regular basis. Patients who survived necrotizing fasciitis suffer from functional impairment and changed body appearance. Assistive devices or pain medication are often required, and the patients present with significantly decreased physical, social, and emotional functioning at the midterm follow-up. The patient's age is a critical factor regarding functional or mental outcome parameters. Further research on the post-hospital course and long-term multidisciplinary care is required to improve the outcomes of these patients.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
Radical surgical intervention is necessary to save patients' lives in cases of necrotizing fasciitis. This leads to persistent disabilities and most likely to a deteriorated quality of life. The purpose of this study was to evaluate the midterm outcomes after survival of necrotizing fasciitis.
MATERIALS AND METHODS METHODS
A retrospective analysis of 69 patients, treated for necrotizing fasciitis between 2003 and 2012. The patients were identified using the International Classification of Diseases (10th Revision) code M 72.6. Of the 50 survivors, 22 patients completed the Short Form 36 and Short Musculoskeletal Function Assessment questionnaires as a postal survey. The follow-up averaged 59 months (range: 6-128 months).
RESULTS RESULTS
The average age at the time of necrotizing fasciitis was 60.0 years. The body mass index average was 29.7. The patients had a significantly decreased physical component summary score of 33.3 compared to a normative group (p < 0.001) (Short Form 36). They further showed a significantly decreased dysfunction and bother indices (Short Musculoskeletal Function Assessment) (p < 0.001). An increased age (⩾70 years) was associated with an inferior role emotional (p = 0.048) and physical functioning (p = 0.011) as well as social functioning (p = 0.038) (Short Form 36). The majority of patients (16, 72.7%) complained of pain at the final follow-up and 50% of patients required an assistive device on a regular basis.
CONCLUSION CONCLUSIONS
Patients who survived necrotizing fasciitis suffer from functional impairment and changed body appearance. Assistive devices or pain medication are often required, and the patients present with significantly decreased physical, social, and emotional functioning at the midterm follow-up. The patient's age is a critical factor regarding functional or mental outcome parameters. Further research on the post-hospital course and long-term multidisciplinary care is required to improve the outcomes of these patients.

Identifiants

pubmed: 31057795
doi: 10.1177/2050312119842433
pii: 10.1177_2050312119842433
pmc: PMC6452519
doi:

Types de publication

Journal Article

Langues

eng

Pagination

2050312119842433

Déclaration de conflit d'intérêts

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Références

J Bone Joint Surg Am. 1999 Sep;81(9):1245-60
pubmed: 10505521
CMAJ. 2000 Aug 8;163(3):265-71
pubmed: 10951722
Spine (Phila Pa 1976). 2000 Dec 15;25(24):3130-9
pubmed: 11124729
J Bone Joint Surg Am. 2002 Feb;84-A(2):208-15
pubmed: 11861726
J Bone Joint Surg Am. 2003 Aug;85-A(8):1454-60
pubmed: 12925624
Crit Care Med. 2004 Jul;32(7):1535-41
pubmed: 15241098
Arch Surg. 2005 Feb;140(2):151-7; discussion 158
pubmed: 15723996
Crit Care Med. 2005 Jul;33(7):1677
pubmed: 16003106
J Microbiol Immunol Infect. 2005 Oct;38(5):361-4
pubmed: 16211146
Gen Hosp Psychiatry. 2007 Jan-Feb;29(1):14-20
pubmed: 17189739
J Emerg Med. 2010 Aug;39(2):261-5
pubmed: 19081698
J Burn Care Res. 2009 Mar-Apr;30(2):301-6
pubmed: 19165118
J Am Coll Surg. 2009 Feb;208(2):279-88
pubmed: 19228540
BMC Infect Dis. 2011 Jan 05;11:5
pubmed: 21208438
Unfallchirurg. 2011 Mar;114(3):197-216
pubmed: 21373930
Am J Surg. 2013 Sep;206(3):368-73
pubmed: 23806825
Colorectal Dis. 2013 Dec;15(12):1529-36
pubmed: 24034257
J Behav Med. 2014 Oct;37(5):967-76
pubmed: 24068563
Burns. 2014 Aug;40(5):848-51
pubmed: 24252250
Br J Surg. 2014 Jan;101(1):e119-25
pubmed: 24338771
J Surg Res. 2014 Nov;192(1):143-9
pubmed: 24923631
Burns. 2015 Mar;41(2):345-51
pubmed: 25234955
J Health Psychol. 2017 Mar;22(3):364-374
pubmed: 26324235
J Emerg Med. 2017 Apr;52(4):523-526
pubmed: 27743718
Ann Plast Surg. 2017 May;78(5):582-586
pubmed: 28379857
J Plast Reconstr Aesthet Surg. 2018 Jun;71(6):857-862
pubmed: 29503165
Am J Surg. 1977 Jul;134(1):52-7
pubmed: 327844
Ann Surg. 1987 Nov;206(5):661-5
pubmed: 3314752
Ann Surg. 1972 May;175(5):702-11
pubmed: 4555030
Am Surg. 1993 May;59(5):304-8
pubmed: 8489099

Auteurs

Christiane Kruppa (C)

Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil Bochum, Ruhr-University Bochum, Bochum, Germany.

Danial J Hutter (DJ)

Research School, Faculty of Medicine, Ruhr-University Bochum, Bochum, Germany.

Matthias Königshausen (M)

Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil Bochum, Ruhr-University Bochum, Bochum, Germany.

Jan Gessmann (J)

Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil Bochum, Ruhr-University Bochum, Bochum, Germany.

Thomas A Schildhauer (TA)

Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil Bochum, Ruhr-University Bochum, Bochum, Germany.

Marlon O Coulibaly (MO)

Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil Bochum, Ruhr-University Bochum, Bochum, Germany.

Classifications MeSH