| Title |
Clinical predictors for severe sepsis in patients with necrotizing fasciitis: an observational cohort study in northern Thailand
|
|---|---|
| Published in |
Infection and Drug Resistance, July 2015
|
| DOI | 10.2147/idr.s85249 |
| Pubmed ID | |
| Authors |
Patcharin Khamnuan, Wilaiwan Chongruksut, Kijja Jearwattanakanok, Jayanton Patumanond, Apichat Tantraworasin |
| Abstract |
Necrotizing fasciitis (NF) is a life-threatening infection of skin and fascia. Its progress is extremely fast, with extensive necrosis. Delay in treatment, with subsequent huge soft tissue loss and associated severe sepsis, remains a major cause of death in the management of NF. The aim of this study was to explore clinical characteristics that may be used to predict severe sepsis in patients with NF, in the context of routine clinical practice in northern Thailand. A retrospective observational cohort study was conducted. The patient cohort in this study consisted of all patients who were diagnosed with NF by surgical or pathological confirmation. The follow-up period started with the admission date and ended with the discharge date. The clinical variables were collected from patients registered at three provincial hospitals in northern Thailand from 2009 to 2012. The clinical predictors for severe sepsis were analyzed using multivariable risk regression. A total of 1,452 patients were diagnosed with NF, either with severe sepsis (n=237 [16.3%]) or without severe sepsis (n=1,215 [83.7%]). From the multivariable analysis, female sex (relative risk [RR] =1.51; 95% confidence interval [CI] =1.04-2.20), diabetes mellitus (RR =1.40; 95% CI =1.25-1.58), chronic heart disease (RR =1.31; 95% CI =1.15-1.49), hemorrhagic bleb (RR =1.47; 95% CI =1.32-1.63), skin necrosis (RR =1.45; 95% CI =1.34-1.57), and serum protein <6 g/dL (RR =2.67; 95% CI =1.60-4.47) were all predictive factors for severe sepsis. The clinical predictors for severe sepsis in patients with suspicion of NF included female sex, diabetes mellitus, chronic heart disease, hemorrhagic bleb, skin necrosis, and serum protein <6 d/dL. The risk ratio was much higher in patients with total protein less than 6 g/dL, which is associated with malnutrition. Therefore, provision of sufficient nutritional support and close monitoring for these clinical predictors may be beneficial to reduce morbidity and mortality. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 37 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 3% |
| Unknown | 36 | 97% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Postgraduate | 4 | 11% |
| Student > Master | 4 | 11% |
| Student > Bachelor | 4 | 11% |
| Student > Doctoral Student | 3 | 8% |
| Researcher | 3 | 8% |
| Other | 8 | 22% |
| Unknown | 11 | 30% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 14 | 38% |
| Nursing and Health Professions | 4 | 11% |
| Pharmacology, Toxicology and Pharmaceutical Science | 3 | 8% |
| Biochemistry, Genetics and Molecular Biology | 2 | 5% |
| Social Sciences | 1 | 3% |
| Other | 1 | 3% |
| Unknown | 12 | 32% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 13 August 2015.
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#18,418,919
of 22,817,213 outputs
Outputs from Infection and Drug Resistance
#1,026
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Outputs of similar age
#189,228
of 263,426 outputs
Outputs of similar age from Infection and Drug Resistance
#11
of 13 outputs
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