Middlemore Hospital, Auckland, New Zealand.
Crit Care Resusc. 2011 Dec;13(4):232-7.
Necrotising fasciitis is a rare, rapidly progressive soft tissue infection associated with extensive necrosis, profound shock and high morbidity and mortality. Incidence worldwide is thought to be increasing.
To investigate the demographics, comorbidities, microbiological features, resource use and outcome of patients with necrotising fasciitis. We aimed to identify factors associated with mortality.
DESIGN, PARTICIPANTS AND SETTING: A retrospective case and chart review was performed in consecutive patients with necrotising fasciitis admitted to the intensive care unit of a tertiary hospital between January 2000 and June 2008.
58 patients with necrotising fasciitis were admitted during the study period. Pacific Islander and Maori peoples were overrepresented. Comorbidities were consistent with previous studies except for a high incidence of gout. Lower limb was the most frequent site of infection (53%). Swelling (83%) and severe pain (76%) were the most common presenting features. Type 2 infection (52%) was more common than type 1 (43%). Mortality was 29%. Recent non-steroidal antiinflammatory drug use was reported by 43% of patients but not associated with mortality. Logistic regression modelling identified Acute Physiology and Chronic Health Evaluation (APACHE) II score, pre-existing abnormal renal function and gout to be associated with mortality.
There is an higher incidence of necrotising fasciitis at our hospital in South Auckland than reported elsewhere. Maori and Pacific Islander people are at increased risk. In our patient sample APACHE II score, preexisting abnormal renal function and gout were associated with mortality.
坏死性筋膜炎是一种罕见的、迅速进展的软组织感染，伴有广泛的坏死、严重的休克以及高发病率和死亡率。据认为，全球的发病率正在上升。
调查坏死性筋膜炎患者的人口统计学、合并症、微生物学特征、资源利用和结局。我们旨在确定与死亡率相关的因素。
设计、参与者和设置：对 2000 年 1 月至 2008 年 6 月期间在一家三级医院重症监护病房连续收治的坏死性筋膜炎患者进行了回顾性病例和图表回顾。
在研究期间，有 58 例坏死性筋膜炎患者入院。太平洋岛民和毛利人比例过高。合并症与以往的研究一致，但痛风的发病率很高。下肢是最常见的感染部位（53%）。肿胀（83%）和严重疼痛（76%）是最常见的首发症状。2 型感染（52%）比 1 型感染（43%）更常见。死亡率为 29%。43%的患者报告最近使用了非甾体抗炎药，但与死亡率无关。逻辑回归模型确定急性生理学和慢性健康评估（APACHE）Ⅱ评分、预先存在的肾功能异常和痛风与死亡率相关。
在我们位于奥克兰南部的医院，坏死性筋膜炎的发病率高于其他地方报告的发病率。毛利人和太平洋岛民的风险增加。在我们的患者样本中，APACHE Ⅱ评分、预先存在的肾功能异常和痛风与死亡率相关。
