Kruppa Christiane, Hutter Danial J, Königshausen Matthias, Gessmann Jan, Schildhauer Thomas A, Coulibaly Marlon O
Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil Bochum, Ruhr-University Bochum, Bochum, Germany.
Research School, Faculty of Medicine, Ruhr-University Bochum, Bochum, Germany.
SAGE Open Med. 2019 Apr 4;7:2050312119842433. doi: 10.1177/2050312119842433. eCollection 2019.
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.
对于坏死性筋膜炎患者，根治性手术干预对于挽救其生命是必要的。这会导致持续性残疾，并且很可能使生活质量下降。本研究的目的是评估坏死性筋膜炎存活患者的中期结局。
对2003年至2012年间接受坏死性筋膜炎治疗的69例患者进行回顾性分析。使用国际疾病分类（第10版）代码M 72.6识别患者。在50名幸存者中，22例患者通过邮寄调查完成了简短健康调查问卷（SF-36）和简短肌肉骨骼功能评估问卷。随访平均时间为59个月（范围：6 - 128个月）。
坏死性筋膜炎发病时的平均年龄为60.0岁。体重指数平均为29.7。与正常对照组相比，患者的生理健康状况总结评分显著降低，为33.3（p < 0.001）（简短健康调查问卷）。他们还表现出功能障碍和困扰指数显著降低（简短肌肉骨骼功能评估）（p < 0.001）。年龄增加（≥70岁）与角色情感（p = 0.048）、生理功能（p = 0.011）以及社会功能（p = 0.038）较差相关（简短健康调查问卷）。大多数患者（16例，72.7%）在末次随访时主诉疼痛，50%的患者经常需要辅助器械。
坏死性筋膜炎存活患者存在功能障碍和身体外观改变。通常需要辅助器械或止痛药物，并且在中期随访时患者的生理、社会和情感功能显著下降。患者年龄是影响功能或心理结局参数的关键因素。需要对出院后病程和长期多学科护理进行进一步研究，以改善这些患者的结局。
