Huang et al identified risk factors for mortality in patients with necrotizing fasciitis. This can help to identify a patient who may require more aggressive management. The authors are from Chi-Mei Medical Center in Tainan, Taiwan.
Patient selection: necrotizing fasciitis
Outcome: mortality
The diagnosis of necrotizing fasciitis is based on surgical appearance of soft tissue with:
(1) dishwater or foul-smelling discharge
(2) necrotic fascia
(3) absence of fascial bleeding
(4) lack of resistance of normal adherence of muscle to fascia
Predictors of mortality:
(1) age > 60 years
(2) cirrhosis
(3) soft tissue air/gas
(4) Aeromonas present
(5) percent bands > 10%
(6) aPTT > 60 seconds
(7) bacteremia
(8) serum creatinine > 2 mg/dL
where:
• Three of the criteria relate to organ failures (cirrhosis, aPTT, serum creatinine).
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