Boyer Alexandre, Vargas Frederic, Coste Fanny, Saubusse Elodie, Castaing Yves, Gbikpi-Benissan Georges, Hilbert Gilles, Gruson Didier
Medical Intensive Care Unit, Hôpital Pellegrin-Tripode, Place Amélie Raba Léon, 33076 Bordeaux cedex, France.
Intensive Care Med. 2009 May;35(5):847-53. doi: 10.1007/s00134-008-1373-4. Epub 2008 Dec 20.
Surgical treatment is crucial in the management of necrotizing soft tissue infections (NSTIs). The aim of this study was to determine the influence of surgical procedure timing on hospital mortality in severe NSTI.
A retrospective study including 106 patients was conducted in a medical intensive care unit equipped with a hyperbaric chamber. Data regarding pre-existing conditions, intensive care and surgical management were included in a logistic regression model to determine independent factors associated with hospital mortality.
Overall hospital mortality was 40.6%. In multivariate analysis, underlying cardiovascular disease, SAPS II, abdominoperineal compared to limb localization, time from the first signs to diagnosis <72 h, and time from diagnosis to surgical treatment >14 h in patients with septic shock were independently associated with hospital mortality.
In patients with NSTI and septic shock, hospital mortality is influenced by the timing of surgical treatment.
手术治疗在坏死性软组织感染（NSTIs）的管理中至关重要。本研究的目的是确定手术时机对严重NSTI患者医院死亡率的影响。
在一个配备高压氧舱的医疗重症监护病房对106例患者进行了一项回顾性研究。将有关既往疾病、重症监护和手术管理的数据纳入逻辑回归模型，以确定与医院死亡率相关的独立因素。
总体医院死亡率为40.6%。在多变量分析中，潜在心血管疾病、简化急性生理学评分系统II（SAPS II）、与肢体部位相比的腹会阴部位、从首发症状到诊断的时间<72小时以及感染性休克患者从诊断到手术治疗的时间>14小时与医院死亡率独立相关。
在患有NSTI和感染性休克的患者中，医院死亡率受手术治疗时机的影响。
