Intensive Care Medicine

, Volume 38, Issue 7, pp 1143–1151

Hyperbaric oxygen therapy in necrotising soft tissue infections: a study of patients in the United States Nationwide Inpatient Sample

  • Chai R. Soh
  • Ricardo Pietrobon
  • John J. Freiberger
  • Sophia T. Chew
  • Dimple Rajgor
  • Mihir Gandhi
  • Jatin Shah
  • Richard E. Moon
Original

DOI: 10.1007/s00134-012-2558-4

Cite this article as:
Soh, C.R., Pietrobon, R., Freiberger, J.J. et al. Intensive Care Med (2012) 38: 1143. doi:10.1007/s00134-012-2558-4

Abstract

Purpose

Necrotising soft tissue infection (NSTI) is a deadly disease associated with a significant risk of mortality and long-term disability from limb and tissue loss. The aim of this study was to determine the effect of hyperbaric oxygen (HBO2) therapy on mortality, complication rate, discharge status/location, hospital length of stay and inflation-adjusted hospitalisation cost in patients with NSTI.

Methods

This was a retrospective study of 45,913 patients in the Nationwide Inpatient Sample (NIS) from 1988 to 2009.

Results

A total of 405 patients received HBO2 therapy. The patients with NSTI who received HBO2 therapy had a lower mortality (4.5 vs. 9.4 %, p = 0.001). After adjusting for predictors and confounders, patients who received HBO2 therapy had a statistically significantly lower risk of dying (odds ratio (OR) 0.49, 95 % confidence interval (CI) 0.29–0.83), higher hospitalisation cost (US$52,205 vs. US$45,464, p = 0.02) and longer length of stay (LOS) (14.3 days vs. 10.7 days, p < 0.001).

Conclusions

This retrospective analysis of HBO2 therapy in NSTI showed that despite the higher hospitalisation cost and longer length of stay, the statistically significant reduction in mortality supports the use of HBO2 therapy in NSTI.

Keywords

Hyperbaric oxygen therapyHealthcare cost and utilisation projectNational inpatient sampleNecrotising soft tissue infections

Copyright information

© Copyright jointly held by Springer and ESICM 2012

Authors and Affiliations

  • Chai R. Soh
    • 1
    • 2
  • Ricardo Pietrobon
    • 1
    • 3
  • John J. Freiberger
    • 4
  • Sophia T. Chew
    • 1
    • 2
  • Dimple Rajgor
    • 1
    • 3
  • Mihir Gandhi
    • 1
    • 5
  • Jatin Shah
    • 1
    • 3
  • Richard E. Moon
    • 3
  1. 1.Duke-NUS Graduate Medical SchoolSingaporeSingapore
  2. 2.Department of AnaesthesiologySingapore General HospitalSingaporeSingapore
  3. 3.Research on Research GroupDuke University Medical CenterDurhamUSA
  4. 4.Center for Hyperbaric Medicine and Environmental PhysiologyDuke University Medical CenterDurhamUSA
  5. 5.Singapore Clinical Research InstituteSingaporeSingapore