Horn et al reported risk factors for death or limb amputation associated with a necrotizing skin and soft tissue infection (NSSTI). These can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Washington and Harborview Medical Center.
Risk factors for mortality:
(1) age > 60 years of age
(2) serum creatinine > 2 mg/dL
(3) WBC count > 30,000 per µL
(4) platelet count < 150,000 per µL
(5) presence of Clostridium deficiencies
Risk factors for limb amputation:
(1) age > 60 years of age
(2) male sex
(3) non-White race
(4) diabetes mellitus
(5) cause of infection a chronic wound
(6) transfer status
(7) serum sodium < 130 mmol/L
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