Chang et al identified a number of factors associated with in-hospital mortality for a patient with necrotizing fasciitis. These can help to identify a patient who may benefit from more aggressive management. The authors are from Chang Gung Memorial Hospital and Kaohsiung Veterans General Hospital in Taiwan.
Patient selection: hospitalized patient with necrotizing fasciitis
Outcome: in-hospital mortality
Predictors for in-hospital mortality on multi-variate analysis:
(1) SOFA score (odds ratio 1.15 per 1-point increase)
(2) blood lactate (odds ratio 1.17)
(3) serum albumin (see below)
(4) cirrhosis (odds ratio 1.05)
Serum Albumin in g/dL
Odds Ratio
> 4.0
1
<= 4.0
2.0
<= 3.5
3.0
<= 3.0
4.9
<= 2.5
8.3
Performance:
• The SOFA score alone had an area under the ROC curve of 0.82.
• Serum albumin alone had an area under the ROC curve of 0.77.
• Both together had an area under the ROC curve of 0.84.
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