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Intensive Care Medicine

, Volume 35, Issue 5, pp 847–853 | Cite as

Influence of surgical treatment timing on mortality from necrotizing soft tissue infections requiring intensive care management

  • Alexandre BoyerEmail author
  • Frederic Vargas
  • Fanny Coste
  • Elodie Saubusse
  • Yves Castaing
  • Georges Gbikpi-Benissan
  • Gilles Hilbert
  • Didier Gruson
Original

Abstract

Purpose

Surgical treatment is crucial in the management of necrotizing soft tissue infections (NSTIs). The aim of this study was to determine the influence of surgical procedure timing on hospital mortality in severe NSTI.

Methods

A retrospective study including 106 patients was conducted in a medical intensive care unit equipped with a hyperbaric chamber. Data regarding pre-existing conditions, intensive care and surgical management were included in a logistic regression model to determine independent factors associated with hospital mortality.

Results

Overall hospital mortality was 40.6%. In multivariate analysis, underlying cardiovascular disease, SAPS II, abdominoperineal compared to limb localization, time from the first signs to diagnosis <72 h, and time from diagnosis to surgical treatment >14 h in patients with septic shock were independently associated with hospital mortality.

Conclusion

In patients with NSTI and septic shock, hospital mortality is influenced by the timing of surgical treatment.

Keywords

Necrotizing fasciitis Septic shock Surgical management Intensive care unit 

Notes

Acknowledgments

The authors thank Tara Embleton, University Hospital Medical Editor, for her valuable advice in editing this manuscript. The authors confirm that there was no grant support.

Conflict of interest statement

The authors have no conflict of interest to declare.

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Alexandre Boyer
    • 1
    Email author
  • Frederic Vargas
    • 1
  • Fanny Coste
    • 1
  • Elodie Saubusse
    • 2
  • Yves Castaing
    • 1
  • Georges Gbikpi-Benissan
    • 1
  • Gilles Hilbert
    • 1
  • Didier Gruson
    • 1
  1. 1.Medical Intensive Care UnitHôpital Pellegrin-TripodeBordeaux cedexFrance
  2. 2.Institut de Santé Publique d’Epidémiologie et de DéveloppementUniversité de Bordeaux 2Bordeaux cedexFrance

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