Factors associated with mortality among patients with necrotizing soft tissue infections: An analysis of 4597 cases using the Diagnosis Procedure Combination Database. (January 2021)

• Record Type: Journal Article
• Authors: Suzuki, Hitoshi; Muramatsu, Keiji; Kubo, Tatsuhiko; Kawasaki, Makoto; Fujitani, Teruaki; Tsukamoto, Manabu; Uchida, Soshi; Fujino, Yoshihisa; Matsuda, Shinya; Sakai, Akinori
• Is Part Of: International journal of infectious diseases. Volume 102(2021)
• Page Start: 73
• Page End: 78
• Publication Date: 2021-01
• Subjects: necrotizing soft tissue infection -- Diagnosis Procedure Combination Database -- in-hospital mortality -- body mass index -- anti-MRSA antibiotic -- antithrombin; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2020.10.019
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: The mortality of necrotizing soft tissue infections (NSTI) in the DPC database was 6.9%. Older age and lower BMI were high risk factors for mortality in NSTI. Sex difference and diabetes at admission had no effect on mortality of NSTI. Abstract: Objective: This study aimed to determine the factors associated with mortality among patients with necrotizing soft tissue infection (NSTI) in Japan using inpatient data from the Diagnosis Procedure Combination (DPC) Database. Methods: We conducted a cross-sectional study using a population retrieved from the Japanese DPC inpatient database of patients who underwent surgical operations from 2014 through 2017. The associations between the covariates and mortality were estimated using multivariate logistic regression models. Results: In total, 4597 patients were registered in this study, with an overall mortality rate of 6.9%. Multilevel logistic regression analysis revealed that higher age, lower body mass index (BMI < 18.5 kg/m 2 ), pre-existing cancer diagnosis, sepsis at admission, maintenance dialysis, antithrombin III use, and anti-methicillin-resistant Staphylococcus aureus (MRSA) antibiotic use were associated with a high mortality rate among NSTI patients. However, sex, underlying diabetes mellitus, ambulance use at admission, intravenous immunoglobulin use, higher hospital case volume, and frequency of operations were not associated with mortality. Conclusion: This study is the first to report the association of lower BMI, antithrombin III use, and anti-MRSA antibiotic use with a higher mortality rate among NSTI patients.