DeGenova Daniel T, Hyland Scott S, Peabody Tucker, Schmitz Nolan P, Myers Devon, Patterson Robert, Patel Jignesh
Orthopedic Surgery, OhioHealth System, Columbus, USA.
Orthopedic Surgery, Naval Medical Center Portsmouth, Portsmouth, USA.
Cureus. 2023 Mar 23;15(3):e36576. doi: 10.7759/cureus.36576. eCollection 2023 Mar.
Purposes This study aims to evaluate further differences between patients with diabetes and those without who have been diagnosed with necrotizing fasciitis (NF) to assist clinicians in improving morbidity and mortality. Methods All patients diagnosed with NF of an extremity were retrospectively reviewed and divided into two groups based on a diagnosis of diabetes. Patient charts were reviewed to obtain multiple variables, which were compared between groups. Results From 2015 to 2021, 115 patients underwent surgical intervention due to concern for NF of an extremity with 92 patients included for data computation. Patients with diabetes had an average Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score of 9.02 compared to 7.24 (p=0.02). Patients with diabetes had a significantly higher rate of undergoing amputation when diagnosed with NF (p<0.0001). The mortality rate for diabetes and non-diabetes cohorts were 30.9% and 18.9%, respectively (p=0.2). Conclusion This study demonstrated that patients with diabetes with confirmed NF of an extremity had a significantly higher LRINEC score were more likely to undergo an amputation primarily, and were more likely to have a polymicrobial infection compared to those without. The overall mortality rate of NF was 26.1%.
目的 本研究旨在进一步评估糖尿病患者与未患糖尿病但被诊断为坏死性筋膜炎（NF）的患者之间的差异，以帮助临床医生降低发病率和死亡率。方法 对所有被诊断为肢体NF的患者进行回顾性研究，并根据糖尿病诊断将其分为两组。查阅患者病历以获取多个变量，并在两组之间进行比较。结果 2015年至2021年，115例因肢体NF接受手术干预的患者中，92例纳入数据计算。糖尿病患者坏死性筋膜炎实验室风险指标（LRINEC）平均评分为9.02，而非糖尿病患者为7.24（p = 0.02）。糖尿病患者被诊断为NF时截肢率显著更高（p < 0.0001）。糖尿病组和非糖尿病组的死亡率分别为30.9%和18.9%（p = 0.2）。结论 本研究表明，确诊为肢体NF的糖尿病患者与未患糖尿病的患者相比，LRINEC评分显著更高，更易接受截肢手术，且更易发生混合菌感染。NF的总体死亡率为26.1%。
