Ertl et al identified prognostic factors for increased mortality for a patient with necrotizing fasciitis of the abdominal wall. These can help to identify a patient who may require more aggressive management. The authors are from Western Michigan University and Michigan State University.
Patient selection: necrotizing fasciitis of the abdominal wall
Outcome: mortality
Risk factors for increased mortality:
(1) elevated serum BUN in mg/dL
(2) elevated serum total bilirubin in mg/dL
(3) prolonged admission to the ICU in days
An older age was associated with mortality with a p value of 0.053.
Parameter
mean survival
survival mean + SD
died mean minus SD
died mean
BUN
23.9
38.9
27.5
57.5
bilirubin
0.85
1.62
0.71
1.96
ICU stay
4.8
11.6
4.2
11.6
Decision
BUN
bilirubin
ICU stay
favor survival
< 27.5
< 0.71
< 4.2
overlap
27.5-39
0.71-1.62
4.2-11.6
favor mortality
> 39
> 1.62
> 11.6
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