Khan Saad, Ahmad Rizwan, Munir Aqsa, Nasir Safa, Adnan Maryam, Naveed Fatima, Idrees Usama, Fatima Syeda Mashal, Iqbal Javed
Saidu Medical College, Khyber Pakhtunkhwa, Pakistan.
Khyber Medical University, Peshawar, Pakistan.
World J Surg. 2025 May;49(5):1210-1218. doi: 10.1002/wjs.12504. Epub 2025 Mar 19.
Necrotizing fasciitis (NF) is a severe and rapidly progressing soft tissue infection with high mortality rates. Despite the urgency of this condition, there is limited research on long-term NF-related mortality trends in the United States.
This study aims to analyze NF-related mortality trends in adults aged 25 and older in the United States from 2003 to 2020, focusing on variations by sex, race/ethnicity, and geographic region.
NF-related deaths were identified using the CDC WONDER database through the ICD-10 code M72.6. Crude and age-adjusted mortality rates (AAMRs) were calculated across demographic groups and regions. Temporal trends were assessed using the joinpoint regression, providing annual percent change (APC) in mortality rates.
From 2003 to 2020, a total of 19,158 NF-related deaths were recorded, marking a 120.6% increase, rising from 824 deaths in 2003 to 1842 in 2020. The overall AAMR increased from 0.44 per 100,000 in 2003 to 0.71 per 100,000 in 2020. Males consistently had higher mortality rates than females and both sexes saw a sharp rise in AAMR after 2015. By race/ethnicity, American Indian or Alaska Native populations exhibited the highest mortality rates, followed by Black or African American individuals. Regional trends revealed that the West had the highest AAMR, whereas the Northeast recorded the lowest. A significant rise in mortality rates was observed across all regions after 2014. Additionally, urban-rural analysis indicated that large central metropolitan areas had consistently elevated mortality rates, whereas smaller metropolitan and noncore areas experienced sharper increases.
NF-related mortality has significantly risen in the United States since 2014, with distinct disparities based on sex, race, and geographic region. Contributing factors may include chronic conditions, healthcare access issues, and climate-related events. Public health interventions focusing on early diagnosis, timely treatment, and addressing healthcare inequities are essential for improving outcomes (highlighted shows corrections).
坏死性筋膜炎（NF）是一种严重且进展迅速的软组织感染，死亡率很高。尽管这种情况很紧急，但美国对坏死性筋膜炎相关的长期死亡率趋势的研究有限。
本研究旨在分析2003年至2020年美国25岁及以上成年人中与坏死性筋膜炎相关的死亡率趋势，重点关注性别、种族/族裔和地理区域的差异。
通过ICD - 10编码M72.6，使用疾病控制与预防中心（CDC）的WONDER数据库识别与坏死性筋膜炎相关的死亡病例。计算各人口群体和地区的粗死亡率和年龄调整死亡率（AAMR）。使用连接点回归评估时间趋势，得出死亡率的年度变化百分比（APC）。
2003年至2020年，共记录了19158例与坏死性筋膜炎相关的死亡病例，增长了120.6%，从2003年的824例死亡增至2020年的1842例。总体年龄调整死亡率从2003年的每10万人0.44例增至2020年的每10万人0.71例。男性的死亡率一直高于女性，2015年后两性的年龄调整死亡率均急剧上升。按种族/族裔划分，美国印第安人或阿拉斯加原住民的死亡率最高，其次是黑人或非裔美国人。区域趋势显示，西部的年龄调整死亡率最高，而东北部最低。2014年后所有地区的死亡率均显著上升。此外，城乡分析表明，大型中心都市区的死亡率一直较高，而较小的都市区和非核心地区的死亡率上升幅度更大。
自2014年以来，美国与坏死性筋膜炎相关的死亡率显著上升，在性别、种族和地理区域方面存在明显差异。促成因素可能包括慢性病、医疗服务可及性问题和与气候相关的事件。侧重于早期诊断、及时治疗和解决医疗不平等问题的公共卫生干预措施对于改善结局至关重要。
