Maria Norma Gomez Herrera

Abstract

Objective: To identify factors associated with necrotizing soft tissue infections (NSTIs) and their mortality in in a public referral hospital in Mexico

Methods: We conducted a retrospective, analytical, longitudinal, and exploratory review of all patients diagnosed with NSTIs over a five-year period. Clinical and demographic data were analyzed to identify factors associated with the development and outcome of the disease in a public referral hospital. Results : Ninety-seven patients met the inclusion criteria (83 men and 14 women; mean age 58.8 ± 17.8 years). Identified risk factors included drug addiction (25.77%), use of immunosuppressants (8.24%), prior surgery (18.55%), diabetes (39.17%), HIV infection (8.24%), peripheral vascular disease (9.27%), and chronic kidney disease (11.34%). Mean serum calcium was 7.9 ± 0.75 mg/dL. Factors significantly associated with mortality included age >65 years, drug addiction, previous surgery, diabetes, and chronic kidney disease (p < 0.05). Drug addiction, and chronic kidney disease, were strongly associated with increased risk of death. All patients who died had lower serum albumin and calcium levels.

Conclusions: In low- and middle-income countries, early surgical intervention to control the source of necrotizing soft tissue infections is essential; however, patient transfer to specialized centers is often delayed, in this population chronic kidney disease and drug addiction were the factors most strongly associated with mortality. Serum albumin and calcium levels were notably lower in all patients who died.