Influence of surgical treatment timing on mortality from necrotizing soft tissue infections requiring intensive care management
Influence of surgical treatment timing on mortality from necrotizing soft tissue infections requiring intensive care management
复制标题
DOI：
10.1007/s00134-008-1373-4
复制
发表时间：
2009-05-01
影响因子：
38.9
通讯作者：
Gruson, Didier
中科院分区：
文献类型：
--
作者：
Boyer, Alexandre;Vargas, Frederic;Gruson, Didier
手术治疗是治疗坏死性软组织感染（NSTI）的关键。本研究的目的是确定手术时机对重症NSTI住院死亡率的影响。关于既往疾病、重症监护和手术治疗的数据纳入logistic回归模型，以确定与住院死亡率相关的独立因素。多因素分析显示，感染性休克患者的基础心血管疾病、SAPS II、腹会阴部与肢体定位、首次体征到诊断的时间< 72 h、诊断到手术治疗的时间> 14 h与住院死亡率独立相关;在NSTI合并感染性休克患者中，住院死亡率受手术治疗时机的影响。
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.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.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.In patients with NSTI and septic shock, hospital mortality is influenced by the timing of surgical treatment.