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Table 2 Relation of treatment characteristics with mortality

From: Outcome of necrotizing fasciitis and Fournier's gangrene with and without hyperbaric oxygen therapy: a retrospective analysis over 10 years

Characteristic Total, n (%) Mortality, n (%)
Yes No Pa
  192 (100) 53 (27.6) 139 (72.4)  
Surgical treatment
 Debridements,b mean (SD) 7.5 (5.3) 5.2 (4.2) 8.3 (5.5)  < 0.001
  ≤ 5 82 (42.7) 32 (60.4) 50 (36.0) 0.002
  > 5 110 (57.3) 21 (39.6) 89 (64.0)  
 Time to 1st debrid. ≤ 12 hc 92 (47.9) 23 (43.4) 69 (49.6) 0.439
 Time to 1st debrid. ≤ 24 h 115 (59.9) 27 (50.9) 88 (63.3) 0.118
 VAC therapy 120 (62.5) 17 (32.1) 103 (74.1)  < 0.001
 VAC changes, mean (SD) 5.3 (4.0) 4.9 (2.6) 5.4 (4.2) 0.855
  ≤ 5 82 (68.3) 9 (52.9) 73 (70.9) 0.141
  > 5 38 (31.7) 8 (47.1) 30 (29.1)  
 Defect closure 135 (70.3) 13 (24.5) 122 (87.8)  < 0.001
  Mesh graft 109 (56.8) 8 (15.1) 101 (72.7)  < 0.001
  Flap 27 (14.1) 1 (1.9) 26 (18.7) 0.003
  Amputationd 46 (24.0) 17 (32.1) 29 (20.9) 0.104
  Secondary healing 37 (19.3) 6 (11.3) 31 (22.3) 0.085
HBOT
 No, not indicated 98 (51.1) 24 (45.3) 74 (53.2) 0.022
 Yes 83 (43.2) 22 (41.5) 61 (43.9)  
 No, ineligiblee 11 (5.7) 7 (13.2) 4 (2.9)  
Antibiotic therapy
 Number of AB, mean (SD) 4.6 (2.2) 4.3 (2.2) 4.8 (2.2) 0.153
  ≤ 3 67 (34.9) 24 (45.3) 43 (30.9) 0.062
  > 3 125 (65.1) 29 (54.7) 96 (69.1)  
 AB groups, mean (SD) 3.3 (1.3) 3.3 (1.5) 3.3 (1.3) 0.885
  ≤ 3 110 (57.3) 29 (54.7) 81 (58.3) 0.656
  > 3 82 (42.7) 24 (45.3) 58 (41.7)  
 Changes of AB, mean (SD) 2.5 (2.1) 2.0 (2.0) 2.7 (2.0) 0.007
  ≤ 2 115 (59.9) 37 (69.8) 78 (56.1) 0.083
  > 2 77 (40.1) 16 (30.2) 61 (43.9)  
Hospital treatment
 ICU treatment 172 (89.6) 52 (98.1) 120 (86.3) 0.017
  Days in ICU, mean (SD) 13.3 (16.1) 13.4 (16.8) 13.2 (16.0) 0.815
  0 days 20 (10.4) 1 (1.9) 19 (13.7) 0.012
  1–7 days 82 (42.7) 30 (56.6) 52 (37.4)  
  > 7 days 90 (46.9) 22 (41.5) 68 (48.9)  
 Days in hospital, mean (SD)f 40.2 (26.3) 22.8 (25.1) 46.8 (23.7)  < 0.001
  ≤ 40 days 109 (56.8) 40 (75.5) 69 (49.6) 0.001
  > 40 days 83 (43.2) 13 (24.5) 70 (50.4)  
Complications
 Total 120 (63.5) 47 (92.2) 73 (52.9)  < 0.001
 Infectionsg 95 (49.5) 25 (47.2) 70 (50.4) 0.693
 Sepsis/organ dysfunctionh 76 (39.6) 45 (84.9) 31 (22.3)  < 0.001
 Impaired wound healing 46 (24.0) 5 (9.4) 41 (29.5) 0.004
 Prolonged delirium 30 (15.6) 4 (7.5) 26 (18.7) 0.057
 Stump complications 14 (7.3) 2 (3.8) 12 (8.6) 0.247
 Decubitus 9 (4.7) 1 (1.9) 8 (5.8) 0.257
 Thrombosis 9 (4.7) 2 (3.8) 7(5.0) 0.711
 Anus praeteri, j 29 (15.1) 5 (9.4) 24 (17.3) 0.259
 Ileusi 4 (2.1) 2 (3.8) 2 (1.4) 0.306
 Strokei 3 (1.6) 1 (1.9) 2 (1.4) 1.000
 Cardiac arresti 3 (1.6) 2 (3.8) 1 (0.7) 0.185
 Other complicationsi, k 11 (5.7) 5 (9.4) 6 (4.3) 0.180
  1. For calculation of percentages, the number of patients in each column (i.e., in the total cohort and in subgroups with and without mortality) was set to 100%
  2. AB antibiotics, debrid. Debridement, HBOT hyperbaric oxygen therapy, ICU intensive care unit, SD standard deviation, VAC vacuum-assisted closure
  3. aCharacteristics of subgroups with and without mortality were compared with Chi-squared test for categorical variables and with Mann–Whitney-U test for continuous variables. Significant differences are highlighted in bold
  4. bDebridements included both radical debridements and minor surgical debridements for wound conditioning performed in our hospital and/or in other hospitals or departments prior to admission to our center
  5. cTime to first debridement was calculated from the time of admission to our clinic until debridement
  6. dIn the subgroup with amputation, n = 2 patients (1.0%) obtained a minor amputation, n = 3 (1.6%) a transtibial amputation, n = 3 (1.6%) a knee disarticulation, n = 34 (17.7%) a transfemoral amputation, n = 5 (1.6%) a hip disarticulation and n = 8 (4.2%) an atypical amputation. 18 patients (9.4%) had a reamputation
  7. en = 11 patients were ineligible for HBOT due to factors specified in Additional file 1: Table S1
  8. fDefined as number of days from admission to our or to an external hospital until discharge from our hospital or death
  9. gInfections comprised externally acquired and nosocomial urinary tract infections (n = 63), Clostridium difficile infections (n = 28), pneumonia (n = 9), wound infections (n = 3) and catheter sepsis (n = 23)
  10. hThe category "sepsis/organ dysfunction" contained patients with sepsis and/or subsequent renal failure and/or failure of additional organs
  11. iExact Fisher-t-test
  12. jIn 29 patients (n = 14 with necrotizing fasciitis and n = 15 with Fournier’s gangrene), colostomy was performed prior to admission to our department
  13. kOther complications comprised acute coronary syndrome (n = 1), gastrointestinal bleeding (n = 3), requirement of resuscitation (n = 2), tumor progression (n = 1), hypoxic brain damage (n = 1), hematuria (n = 1), stoma complications (n = 1) and biliary stent occlusion (n = 1)