Celik Kaan, Danis Faruk, Kudu Emre
Department of Emergency Medicine, Bolu Abant Izzet Baysal University Faculty of Medicine, Bolu, Turkiye.
Department of Emergency Medicine, Marmara University Pendik Training and Research Hospital, Istanbul, Turkiye.
North Clin Istanb. 2025 Jun 18;12(3):307-313. doi: 10.14744/nci.2024.94557. eCollection 2025.
Necrotizing fasciitis (NF) is a severe and potentially life-threatening soft tissue infection characterized by rapid necrosis, primarily affecting the fascia and deep soft tissues. Despite its low incidence, NF poses significant challenges due to its aggressive nature and high mortality rates. This retrospective study aimed to assess clinical characteristics and prognostic factors influencing mortality rates among patients diagnosed with NF at a tertiary care facility.
Patients diagnosed with NF at the emergency department of tertiary care hospital in Turkiye between August 1, 2017, and July 31, 2023, were included in the study. Demographic data, clinical features, underlying factors, laboratory findings, and outcomes were reviewed.
A total of 69 adult patients were included in the study. Among cases, 51 survived (73.5%) and 18 died (26.5%). There were 43 males (62.3%) and 26 females (37.7%) with a mean age of 55.8±16.1 years. The most common symptoms were pain/tenderness (84.1%), erythema (75.4%), local swelling (72.5%), and crepitus (44.9%). Diabetes mellitus, lower systolic blood pressure, higher pulse rates, elevated white blood cell counts, and polymicrobial infections were associated with poor outcomes (p<0.001, p=0.020, p<0.001, p=0.016, and p<0.001, respectively).
NF is a rare surgical emergency. Early diagnosis, prompt intervention, and multidisciplinary management are crucial in mitigating NF's devastating consequences. Recognizing poor prognosis factors in patients can guide their management.
坏死性筋膜炎（NF）是一种严重且可能危及生命的软组织感染，其特征为迅速坏死，主要累及筋膜和深部软组织。尽管NF发病率较低，但因其侵袭性本质和高死亡率而带来重大挑战。本回顾性研究旨在评估在一家三级医疗机构诊断为NF的患者的临床特征及影响死亡率的预后因素。
纳入2017年8月1日至2023年7月31日期间在土耳其一家三级医院急诊科诊断为NF的患者。回顾人口统计学数据、临床特征、潜在因素、实验室检查结果及结局。
本研究共纳入69例成年患者。其中，51例存活（73.5%），18例死亡（26.5%）。有43例男性（62.3%）和26例女性（37.7%），平均年龄为55.8±16.1岁。最常见的症状为疼痛/压痛（84.1%）、红斑（75.4%）、局部肿胀（72.5%）和气肿（44.9%）。糖尿病、较低的收缩压、较高的脉搏率、白细胞计数升高及多微生物感染与不良结局相关（分别为p<0.001、p=0.020、p<0.001、p=0.016和p<0.001）。
NF是一种罕见的外科急症。早期诊断、及时干预和多学科管理对于减轻NF的毁灭性后果至关重要。识别患者的不良预后因素可指导其治疗。
