Semnicatifia potentiala a prognosticului indicatorului de risc de laborator pentru fasceita necrozanta (LRINEC) in cazurile de fascetia necrozanta
| Autor: | Ahmet Muzaffer Er, Ferda Nihat Koksoy, Okan Demiray, Ahmet Serkan Ilgun, Gulay Kır, Samed Sayar, Dogan Gonullu |
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| Přispěvatelé: | Kır, Gülay, Gönüllü, Doğan, İlgün, Ahmet Serkan, Demiray, Okan, Sayar, Samed, Er, Ahmet Muzaffer, Köksoy, Ferda Nihat, School of Medicine, Department of Anesthesiology and Reanimation |
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty Cardiomyopathy 030230 surgery Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Diabetes mellitus medicine Humans Fasciitis Necrotizing Stage (cooking) Fasciitis Retrospective Studies Necrotizing fasciitis Laboratory risk indicator for necrotizing fasciitis Wang and Wong stages Treatment of necrotizing fasciitis business.industry Mortality rate Soft tissue Middle Aged medicine.disease Prognosis Perineum 030104 developmental biology medicine.anatomical_structure Heart failure Surgery Female business |
| Zdroj: | Chirurgia (Bucharest, Romania: 1990) |
| ISSN: | 1221-9118 |
| Popis: | Background: we discuss the role of Laboratory Risk Indicator for the Necrotizing Fasciitis (LRINEC) on the prognosis of this disease. Necrotizing Fasciitis (NF) is characterised by rapid spreading of infection and necrosis of the soft tissues and fascia. Methods: thirty patients (17 male, 13 female, mean age 57.5 years) were treated between 2011-2016 (in our center); they were analysed retrospectively regarding age, sex, isolated microbiological agents, modalities of treatment and mortality rate. Results: the majority of the infections were detected in the perineum (14 patients). Other sites of infection were: the presacral region (3 patients), as well as abdominal region after elective (10 patients) and emergency surgery (2 patients), respectively. 53.3% of patients had at least one predisposing comorbid factor such as diabetes mellitus, hypertension, cardiomyopathy and congestive heart failure. The tissue cultures were positive in 12 patients. Mean LRINEC score on admission was 8.5 +/- 2.85. There was a strong correlation between LRINEC score and patient age (p=0.018, R=0.43). LRINEC score was affected by neither gender nor the presence of any comorbidities. The patients were classified according to Wang and Wong staging system, as follows: one patient in stage 1, 15 patients in stage 2 and 14 patients in stage 3. Patients with higher Wang and Wong stages had significantly higher LRINEC scores. The mortality rate was 16.7%. The mean LRINEC score of deceased patients compared to patients who were successfully treated was 9.2 +/- 2.2 and 8.36 +/- 2.9. Conclusion: even though LRINEC score and Wang and Wong stage were significatly related with ICU stay, their direct effect on mortality wasn't significant in our study. / Context: discutăm despre rolul indicatorului de risc de laborator pentru fasceita necrozantă (LRINEC) asupra prognosticului acestei boli. Fasceita necrozantă (NF) se caracterizează prin răspândirea rapidă a infecţiei şi a necrozei ţesutului moale şi a fasciei. Metode: Treizeci de pacienţi (17 bărbaţi, 13 femei, vârsta medie 57,5 ani) au fost trataţi în perioada 2011-2016; au fost analizaţi retrospectiv în ceea ce priveşte vârsta, sexul, agenţii microbiologici izolaţi, modalităţile de tratament şi rata mortalităţii. Rezultate: Majoritatea infecţiilor au fost detectate în perineu (14, 46,7%), alte localizări ale infecţiei fiind regiunea presacrală (3, 10%), regiunea abdominală după intervenţie chirurgicală de elecţie (10,33,3%) şi intervenţie chirurgicală de urgenţă (2, 6.7%). 53,3% dintre pacienţi au prezentat cel puţin un factor comorbid predispozant, cum ar fi diabetul zaharat, hipertensiunea, cardiomiopatia şi insuficienţa cardiacă congestivă. Culturile de ţesut au fost pozitive la 12 (40%) pacienţi. Scorul mediu LRINEC la internare a fost de 8,5 ± 2,85. A existat o corelaţie puternică între scorul LRINEC şi vârsta pacientului (p = 0,018, R = 0,43). Scorul LRINEC nu a fost afectat nici de sex, nici de prezenţa oricăror comorbidităţi. Pacienţii au fost clasificaţi conform sistemului de stadializare Wang şi Wong: 1 pacient în stadiul 1 (3,3%), 15 în stadiul 2 (50%) şi 14 în stadiul 3 (46,7%); pacienţii cu stadii Wang şi Wong mai mari aveau scoruri LRINEC semnificativ mai ridicate. Rata mortalităţii este de 16,7%. Scorul mediu LRINEC al pacienţilor decedaţi a fost de 9,2 ± 2,2 şi al pacienţii în viaţă de 8,36 ± 2,9. Concluzii: Chiar dacă scorul LRINEC şi stadiul Wang şi Wong au fost semnificativ legate de internarea la terapie intensivă, efectul lor direct asupra mortalităţii nu a fost semnificativ în studiul nostru. NA |
| Databáze: | OpenAIRE |
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