Uremia as a predictor of Necrotizing Fasciitis

Author(s):
Jasmine Patel; Ghulam Saadat; Jessica Tullington; James Alford Flippin; Laura Brown; Faran Bokhari

Background:

Necrotizing fasciitis(NF) causes mortality from uncontrolled sepsis. Early identification of NF and source control is important to increasing survival. NF can be identified using cumbersome scoring systems. The objective of the study was to identify simple usable markers to predict the need for surgical intervention.

Hypothesis:

NF can be predicted from routine pre-operative labs.

Methods:

Using NSQIP 2018 – 2021 patients > 18 years old with diagnosis of NF, demographic information, comorbidities, preoperative data, and other values from hospital stay were collected. A univariate and multivariate analysis was performed to examine outcomes.

Results:

A total of 2203 patients were included in the NF cohort. On Multivariate analysis elevated BUN, Cr, Albumin (<0.001), Sepsis (<0.001) and septic shock (<0.001) were significantly associated with mortality, as was Hispanic ethnicity (<0.001).

Conclusions:

NF causes mortality from sepsis. Uremia is an independent factor predictive of mortality in NF. Uremia might be able to predict the onset of NF.