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Necrotizing fasciitis: 11‐year retrospective case review in S outh A uckland
Author(s) -
Kulasegaran Suheelan,
Cribb Benjamin,
Vandal Alain C.,
McBride Stephen,
Holland David,
MacCormick Andrew D.
Publication year - 2016
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.13232
Subject(s) - fasciitis , medicine , incidence (geometry) , clindamycin , retrospective cohort study , odds ratio , confidence interval , penicillin , medical record , surgery , antibiotics , microbiology and biotechnology , physics , optics , biology
Background The aims of this paper were to review our experience with necrotizing fasciitis at M iddlemore H ospital and to define the trends in incidence, inpatient mortality and microbiological profile. Methods A computerized search of the electronic medical records was undertaken to identify adult patients with a diagnosis of necrotizing fasciitis between J anuary 2000 and D ecember 2010. A retrospective review of the clinical records was performed. Results Of the 138 patients with necrotizing fasciitis identified, 129 had their diagnosis confirmed at operation. The mortality at 30 days was 20.3% (95% confidence interval ( CI ) 13.9%–28.0%). There was a significant reduction in hospital mortality in each successive year of the study period with an odds ratio of 0.84 (95% CI 0.71–0.98, P = 0.03). A pattern of increasing incidence was noted until F ebruary 2004 (95% CI S eptember 2002– J uly 2005). This was followed by a significant decrease in incidence. The empirical antibiotic regime of clindamycin, gentamicin and penicillin provides satisfactory cover against 95% of the causative pathogens. Conclusion This represents the largest single‐centre published case series in N ew Z ealand. Despite concerns of increasing incidence and mortality associated with necrotizing fasciitis in N ew Z ealand, the experience in S outh A uckland shows a decrease in incidence of necrotizing fasciitis since 2004 and a statistically significant decreasing trend in hospital mortality.