Which factors are positive predictors of mortality from necrotizing fasciitis?

Updated: Oct 17, 2018
  • Author: Steven A Schulz, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

A retrospective study by Hsiao et al found that Aeromonas infection, Vibrio infection, cancer, hypotension, and band form WBC count greater than 10% were independent positive predictors of mortality in patients with necrotizing fasciitis, while streptococcal and staphylococcal infections were not identified as predictors of mortality. Hemorrhagic bullae appeared to be an independent negative predictor of mortality. However, accuracy of these factors needs to be verified. [42]

A retrospective cohort study by Chang et al of patients with necrotizing fasciitis who underwent amputation reported that in those individuals in whom amputation was performed more than 3 days after admission, the mortality risk was higher when hemorrhagic bullae, peripheral vascular disease, or bacteremia was present or the laboratory risk indicator for necrotizing fasciitis (LRINEC) score was over 8. The investigators recommended that in cases in which any of these risk factors is present, amputation not be delayed more than 3 days postadmission. [43]


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