Department of General Surgery, Rutgers-New Jersey Medical School, Newark, NJ, USA.
Department of Surgery, Livingston, NJ, USA.
J Invest Surg. 2022 Jun;35(6):1279-1286. doi: 10.1080/08941939.2022.2043960. Epub 2022 Feb 28.
Necrotizing soft-tissue infection (NSTI) is a medical emergency. We investigated the impact of racial, socioeconomic disparities, and comorbidities on mortality, complications, length of stay, and charges in patients with NSTI. Data were acquired from the National Inpatient Sample from Q4 2015 to 2017. ICD-10, Clinical Modification codes were utilized to identify relevant cases. Logistic regression was used to assess socioeconomic, racial, and health risk factors for adverse outcomes in NSTI patients. Of 16,071,053 cases identified during the study period, 15,078 (0.094%) NSTI cases were recognized. Black patients had increased odds of amputation (OR 1.40 95% CI 1.24-1.58, 0.001), prolonged hospital stay (OR 1.40 95% CI 1.24-1.58, 0.001), excessive charges (OR 1.22 95% CI 1.03-1.43, 0.019), and adverse discharge disposition (OR 1.32 95% CI 1.19-1.46, 0.001) compared to white patients. Hispanic patients had increased odds of mortality (OR 1.30 95% CI 1.05-1.60, 0.014) and amputation (OR 1.21 95% CI 1.04-1.42, 0.016) compared to white patients. Medicare patients had increased odds of mortality (OR 1.35 95% CI 1.09-1.67, 0.006), Medicaid patients had increased odd of amputation (OR 1.33 95% CI 1.17-1.51, 0.001) and prolonged LOS (OR 1.33 95% CI 1.17-1.51, 0.001). Patients in the lower income quartiles had decreased odds of amputation compared to the highest income quartile, including the 26 to 50 income quartile (OR 0.84 95% CI 0.73-0.98, 0.022) and 51 to 75 income quartile (OR 0.84 95% CI 0.73-0.98, 0.022). Racial and socioeconomic disparities exist for patients being treated for NSTIs.
坏死性软组织感染 (NSTI) 是一种医疗急症。我们研究了种族、社会经济差异和合并症对 NSTI 患者死亡率、并发症、住院时间和费用的影响。数据来自 2015 年第四季度至 2017 年的国家住院患者样本。使用国际疾病分类第 10 次修订版（ICD-10）临床修正代码来确定相关病例。使用逻辑回归评估 NSTI 患者的社会经济、种族和健康风险因素对不良结局的影响。在研究期间，共确定了 16071053 例病例，其中 15078 例（0.094%）为 NSTI 病例。黑人患者截肢的可能性增加（OR 1.40，95%CI 1.24-1.58， 0.001），住院时间延长（OR 1.40，95%CI 1.24-1.58， 0.001），费用过高（OR 1.22，95%CI 1.03-1.43， 0.019），出院处置不良（OR 1.32，95%CI 1.19-1.46， 0.001），与白人患者相比。与白人患者相比，西班牙裔患者的死亡率（OR 1.30，95%CI 1.05-1.60， 0.014）和截肢率（OR 1.21，95%CI 1.04-1.42， 0.016）增加。与白人患者相比，医疗保险患者的死亡率（OR 1.35，95%CI 1.09-1.67， 0.006）增加，医疗补助患者的截肢率（OR 1.33，95%CI 1.17-1.51， 0.001）和住院时间延长（OR 1.33，95%CI 1.17-1.51， 0.001）增加。与收入最高的四分位数相比，收入较低的四分位数患者截肢的可能性降低，包括 26 至 50 收入四分位数（OR 0.84，95%CI 0.73-0.98， 0.022）和 51 至 75 收入四分位数（OR 0.84，95%CI 0.73-0.98， 0.022）。在接受 NSTI 治疗的患者中存在种族和社会经济差异。
