Factors associated with mortality among patients with necrotizing soft-tissue infections: An analysis of 4597 cases using the Diagnosis Procedure Combination Database

被引：9

作者：

Suzuki, Hitoshi ^{[1
]}

Muramatsu, Keiji ^{[2
]}

Kubo, Tatsuhiko ^{[3
]}

Kawasaki, Makoto ^{[1
]}

Fujitani, Teruaki ^{[1
]}

Tsukamoto, Manabu ^{[1
]}

Uchida, Soshi ^{[4
]}

Fujino, Yoshihisa ^{[5
]}

Matsuda, Shinya ^{[2
]}

Sakai, Akinori ^{[1
]}

机构：

[1] Univ Occupat & Environm Hlth, Dept Orthoped, 1-1 Iseigaoka, Kitakyushu, Fukuoka 8078555, Japan

[2] Univ Occupat & Environm Hlth, Sch Med, Dept Prevent Med & Community Hlth, 1-1 Iseigaoka, Kitakyushu, Fukuoka 8078555, Japan

[3] Hiroshima Univ, Grad Sch Biomed & Hlth Sci, Dept Publ Hlth & Hlth Policy, Minami Ku, 1-2-3 Kasumi, Hiroshima 7340037, Japan

[4] Univ Occupat & Environm Hlth, Wakamatsu Hosp, Dept Orthoped, 1-17-1 Hamamachi, Kitakyushu, Fukuoka 8080024, Japan

[5] Univ Occupat & Environm Hlth, Inst Ind Ecol Sci, Dept Environm Epidemiol, 1-1 Iseigaoka, Kitakyushu, Fukuoka 8078555, Japan

来源：

INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES | 2021年 / 102卷

基金：

日本学术振兴会;

关键词：

Necrotizing soft tissue infection; Diagnosis Procedure Combination Database; In-hospital mortality; Body mass index; Anti-MRSA antibiotic; Antithrombin; TOXIC-SHOCK-SYNDROME; INTRAVENOUS IMMUNOGLOBULIN; FASCIITIS; EPIDEMIOLOGY; MANAGEMENT; IMPACT;

D O I：

10.1016/j.ijid.2020.10.019

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

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 antiMRSA antibiotic use with a higher mortality rate among NSTI patients. (C) 2020 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

引用

页码：73 / 78

页数：6