GS15 *NECROTISING FASCIITIS‐ ANALYSIS OF MORTALITY IN VICTORIA, AUSTRALIA

Background:   Necrotising fasciitis is a soft tissue infection with progressive tissue necrosis, affecting the deep fascial layers. It is a rare life‐threatening disease with mortality rates from 6.1–43%. Many factors have been associated with increased mortality. The aim of this study is to re‐evaluate these factors by analysing data from a larger patient series than any presented in the published literature to date. Methods:   The medical records of 151 sequential patients with necrotising fasciitis treated in the Alfred Hospital from 1997–2004 were reviewed to identify the factors associated with increased mortality. The data was then analysed with multivariate analysis to identify the statistically significant factors. Results:   Mortality rate of this study was 11.3%. The statistically significant factors were CRP > 200 on admission (p = 0.018), mechanical ventilation on admission (p = 0.002), older age (p = 0.0231), male (p = 0.013), delayed hyperbaric therapy from first symptoms (p = 0.045), spontaneous precipitant (p = 0.015), and complications of multi organ failure (p = 0.006), acute renal failure (0.011), acidosis (p = 0.001) or atrial fibrillation (p = 0.001), sepsis (p = 0.045). Conclusions:   The knowledge of these factors will assist in the management of necrotising fasciitis by prioritising these patients, allocating more appropriate resources to prevent delay in hyperbaric treatment and by promptly treat the disease, especially in ICU setting to prevent complications and improve survival.