坏死性软组织感染：急性生理与慢性健康状况评分系统II、扩散及生存情况
Necrotizing soft tissue infections: APACHE II score, dissemination, and survival.
作者信息
Yilmazlar Tuncay, Ozturk Ersin, Alsoy Alpaslan, Ozguc Halil
机构信息
Department of General Surgery, Uludag University School of Medicine, Gorukle Kampusu, Bursa, 21900, Turkey.
Uludag Universitesi Tip Fak. Genel Cerrahi ABD, Gorukle, Bursa, Turkey.
出版信息
World J Surg. 2007 Sep;31(9):1858-1862. doi: 10.1007/s00268-007-9132-1.
BACKGROUND
First described more than a century ago, necrotizing soft tissue infections (NSTIs) continue to cause high mortality and morbidity. The aim of this study was to elucidate the factors affecting the outcome of patients presenting with an NSTI.
METHODS
To determine the factors affecting mortality from NSTIs, the records of 67 patients were retrospectively assessed for the following parameters: age, sex, time between initiation of symptoms and admission to the clinic, presence of systemic coexisting disease, APACHE II score, origin of infection, dissemination of the NSTI, and method of therapy.
RESULTS
The patients were 41 men (61.2%) and 26 women (38.8%) with a mean age of 54.9 +/- 1.73 years. The overall mortality rate was 49% (33/67). Multivariate analysis determined that APACHE II scores of 13 or higher (p = 0.001) and NSTI dissemination (p = 0.02) were risk factors affecting the mortality of patients with NSTIs.
CONCLUSION
By considering these two factors, more accurate outcome prediction may be possible, which may be useful for directing the management of patients with NSTIs.
背景
坏死性软组织感染（NSTIs）早在一个多世纪前就有描述，但其仍导致高死亡率和高发病率。本研究的目的是阐明影响NSTIs患者预后的因素。
方法
为确定影响NSTIs死亡率的因素，对67例患者的记录进行回顾性评估，评估以下参数：年龄、性别、症状出现至入院就诊的时间、是否存在全身性并存疾病、急性生理与慢性健康状况评分系统（APACHE II）得分、感染源、NSTIs的扩散情况以及治疗方法。
结果
患者中男性41例（61.2%），女性26例（38.8%），平均年龄54.9±1.73岁。总死亡率为49%（33/67）。多因素分析确定，APACHE II得分13分及以上（p = 0.001）和NSTIs扩散（p = 0.02）是影响NSTIs患者死亡率的危险因素。
结论
通过考虑这两个因素，可能实现更准确的预后预测，这可能有助于指导NSTIs患者的管理。
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