Survival and Health-Related Quality of Life after Hospitalization for Necrotizing Soft Tissue Infections of the Upper Extremity: A Long-Term Outcome Study.

Autor: Nawijn F; Department of Surgery, University Medical Center Utrecht, CX Utrecht, The Netherlands.; Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, United States., Verhiel SHWL; Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, United States., Nierich J; Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, United States., Eberlin KR; Division of Plastic and Reconstructive Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, United States., Hietbrink F; Department of Surgery, University Medical Center Utrecht, CX Utrecht, The Netherlands., Chen NC; Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, United States.
Jazyk: angličtina
Zdroj: Journal of hand and microsurgery [J Hand Microsurg] 2020 May 06; Vol. 14 (3), pp. 188-196. Date of Electronic Publication: 2020 May 06 (Print Publication: 2022).
DOI: 10.1055/s-0040-1710200
Abstrakt: Introduction  The main aim of the study was to investigate the survival and health-related quality of life (HRQoL) after hospitalization for necrotizing soft tissue infections (NSTIs) of the upper extremity. Materials and Methods  A retrospective study with long-term follow-up of patients surviving NSTIs of the upper extremity was performed. Survival and HRQoL after hospital discharge were the primary outcomes. The HRQoL was measured using the 36-item Short Form (SF-36), EuroQoL-5D-5L (EQ-5D), Quick Disability of Shoulder, Arm and Hand (QuickDASH), and numeric rating scales (NRS) for satisfaction with appearance and pain. Results  A median of 6.5 years after hospitalization, 81% of the 108 patients survived. The response rate was 45% ( n = 38). The SF-36 score was 80 (interquartile range [IQR]: 58-91), the EQ-5D score 1.4 (IQR: 1.2-2.2), the EuroQoL-Visual Analog Scale score 77 (IQR: 67-90), the QuickDASH score 13.6 (IQR: 2.3-30.7), the NRS for satisfaction with appearance 8 (IQR: 7-9), and NRS for pain 1 (IQR: 0-5). Conclusion  Six-and-a-half years after the NSTI, 81% of the patients were still alive. General health prior to the NSTI mainly influenced the risk at secondary mortality. In surviving patients, the HRQoL varied widely, but was adversely affected by female sex, intravenous drug use, NSTI type I or III, and longer length of hospital stay.
Competing Interests: Conflict of Interest K.R.E. is a consultant for AxoGen and Integra. N.C.C. received grants from Miami Device Solutions, OMeGA, and Acumed. All other authors have no conflicts of interest to declare. Note Informed consent was obtained from all patients for being included in the study. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.
(Society of Indian Hand Surgery & Microsurgeons. All rights reserved.)
Databáze: MEDLINE
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