Is overweight a predictor for a more severe course of disease in cases of necrotizing fasciitis?

Purpose: Necrotizing fasciitis is a rare but severe soft tissue infection, and its diagnosis is difficult and often delayed. Immediate treatment comprising extensive debridement, highly dosed broad-spectrum antibiotic therapy and intensive care is necessary to prevent fatal outcomes. Considering the...

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Publicado en:European Journal of Trauma & Emergency Surgery Vol. 50; no. 6; pp. 3319 - 3329
Autores principales: Illg, Claudius, Denzinger, Markus, Rachunek, Katarzyna, Farzaliyev, Farhad, Thiel, Johannes T., Daigeler, Adrien, Krauss, Sabrina
Formato: pictorial research tables/charts Journal Article
Publicado: Springer Nature Dec2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2024
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00068-024-02638-0
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        atl: Is overweight a predictor for a more severe course of disease in cases of necrotizing fasciitis?
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          Illg, Claudius
          Denzinger, Markus
          Rachunek, Katarzyna
          Farzaliyev, Farhad
          Thiel, Johannes T.
          Daigeler, Adrien
          Krauss, Sabrina
        affil: https://ror.org/03a1kwz48 Department of Hand, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen, Schnarrenbergstrasse 95, 72076, Tuebingen, Germany
      sug:
        subj:
          Fasciitis, Necrotizing Pathology
          Severity of Illness
          Disease Progression Risk Factors
          Obesity
          Risk Assessment
          Fasciitis, Necrotizing Therapy
          Treatment Outcomes
          Fasciitis, Necrotizing Mortality
          Human
          Retrospective Design
          Record Review
          Trauma Centers
          Germany
          Sepsis
          Comparative Studies
          Body Weight
          Respiration, Artificial
          Catecholamines Therapeutic Use
          Treatment Duration
          Fatal Outcome
      ab: Purpose: Necrotizing fasciitis is a rare but severe soft tissue infection, and its diagnosis is difficult and often delayed. Immediate treatment comprising extensive debridement, highly dosed broad-spectrum antibiotic therapy and intensive care is necessary to prevent fatal outcomes. Considering the global rise in overweight patients and the known negative effects of obesity on the immune system, the aim of this study was to analyze whether overweight results in a more severe course of necrotizing fasciitis, worse outcomes and an increased mortality rate among overweight patients compared than in normal weight patients. Methods: The present study involved a retrospective analysis of 29 patients who were treated for necrotizing fasciitis in our level one trauma center during the eight-year period between 2013 and 2020. Based on their BMIs, the patients were assigned to either the overweight group (BMI > 25) or the normal weight group. Results: In the study population, being overweight appeared to be a predictor for a more severe course of necrotizing fasciitis. Overweight patients suffered from sepsis significantly more often than normal weight patients (13 vs. 5; p = 0.027). Furthermore, they were dependent on invasive ventilation (26.6 ± 33.8 vs. 5.9 ± 11.9 days; p = 0.046) as well as catecholamine support (18.4 ± 23.7 vs. 3.6 ± 5.7 days; p = 0.039) for significantly longer. Conclusion: Necrotizing fasciitis remains a challenging and potentially fatal disease. Within the patient collective, the severity of the disease and treatment effort were increased among overweight patients.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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