Table 2.
Care trajectory in patients with necrotizing soft tissue infections (n = 170) according to immunosuppression and abdomino-perineal location status
| N | Total | Other locations | Abdomino-perineal NSTIs | P-value | No immunosuppression | Immunosuppression | P-value | |
|---|---|---|---|---|---|---|---|---|
| N = 170 | N = 137 | N = 33 | N = 127 | N = 43 | ||||
| Hospital trajectory data | ||||||||
| Length of ICU stay (days) | 170 | 8 [3–17] | 9 [4–17] | 5 [2–19] | 0.207 | 8 [4–17] | 9 [2–15] | 0.500 |
| Length of hospital stay (days) | 170 | 37 [14–71] | 36 [14–69] | 39 [16–71] | 0.762 | 39 [16–71] | 23 [9–63] | 0.070 |
| Delay admission surgery (days) | 168 | 1 [0 – 2] | 1 [0 – 2] | 1 [0 – 1] | 0.495 | 1 [0–2] | 1 [1–5] | 0.004 |
| Annual NSTI procedural volume | 170 | 0.601 | 0.638 | |||||
| < 3/year | 38 (22.3) | 29 (21.2) | 9 (27.3) | 30 (23.6) | 8 (18.6) | |||
| ≥ 3/year | 132 (77.6) | 108 (78.8) | 24 (72.7) | 97 (76.4) | 35 (81.4) | |||
| Inter-hospital transfer | 168 | 0.934 | 0.484 | |||||
| No | 80 (47.6%) | 65 (48.1) | 15 (45.5) | 62 (49.6) | 18 (41.9) | |||
| Yes | 88 (52.4%) | 70 (51.9) | 18 (54.5) | 63 (50.4) | 25 (58.1) | |||
| Type of structure after ICU | 168 | 0.045 | 0.034 | |||||
| Medical ward | 85 (50.6) | 74 (54.8) | 11 (33.3) | 58 (46.0) | 27 (64.3) | |||
| Rehabilitation | 10 (6.0) | 9 (6.7) | 1 (3.0) | 10 (7.9) | 0 | |||
| Plastic surgery | 16 (9.5) | 13 (9.6) | 3 (9.1) | 15 (11.9) | 1 (2.4) | |||
| Other surgical ward | 57 (33.9) | 39 (28.9) | 18 (54.5) | 43 (34.1) | 14 (33.3) | |||
| Management during hospital course | ||||||||
| Mechanical ventilation | 166 | 86 (51.8) | 69 (51.5) | 17 (53.1) | 0.999 | 63 (50.8) | 23 (54.8) | 0.791 |
| Vasopressor support | 167 | 129 (77.2) | 105 (77.8) | 24 (75.0) | 0.918 | 97 (77.6) | 32 (76.2) | 0.999 |
| Renal replacement therapy | 166 | 46 (27.7) | 38 (28.4) | 8 (25.0) | 0.872 | 30 (24.2) | 16 (38.1) | 0.123 |
| Organ failure | 167 | 134 (80.2) | 110 (81.5) | 24 (75.0) | 0.561 | 101 (80.0) | 34 (81.0) | 0.999 |
| Skin grafting | 167 | 54 (32.3) | 46 (34.1) | 8 (25.0) | 0.437 | 46 (36.8) | 8 (19.0) | 0.053 |
| Skin grafting-first surgery (days) | 36 | 28 [13 – 39] | 28 [13 – 39] | 29 [18 – 43] | 0.999 | 25 [13 – 38] | 34 [31 – 40] | 0.348 |
| Amputation | 166 | 26 (15.7) | 24 (17.9) | 2 (6.3) | 0.174 | 22 (17.7) | 4 (9.5) | 0.307 |
| Negative pressure therapy | 167 | 62 (37.1) | 46 (34.3) | 16 (48.5) | 0.191 | 51 (40.8) | 11 (26.2) | 0.131 |
| Number of additional debridements | 166 | 1 [0–3] | 1 [0–3] | 3 [1–6] | < 0.001 | 2 [0–3] | 1 [0–2] | 0.041 |
| Outcomes | ||||||||
| ICU Mortality | 170 | 37 (21.8) | 30 (21.9) | 7 (21.2) | 0.999 | 21 (16.5) | 16 (37.2) | 0.009 |
| Complicated hospital coursea | 169 | 123 (72.8) | 97 (71.3) | 26 (78.8) | 0.518 | 89 (70.6) | 34 (79.1) | 0.382 |
| In-hospital mortality | 170 | 49 (28.8) | 40 (29.2) | 9 (27.3) | 0.996 | 26 (20.5) | 23 (53.5) | < 0.001 |
| Number of debridements > 3 | 166 | 62 (37.3) | 18 (13.4) | 13 (40.6) | < 0.001 | 27 (21.8) | 4 (9.5) | 0.126 |
| Hospital stay > 6 weeks | 170 | 156 (91.8) | 62 (45.3) | 16 (48.5) | 0.889 | 61 (48.0) | 17 (39.5) | 0.430 |
| Re-hospitalization within 6 months of ICU discharge | 106 | 66 (62.3) | 49 (57.6) | 17 (81.0) | 0.085 | 56 (62.9) | 10 (58.8) | 0.963 |
| ICU readmission within 6 months | 89 | 9 (10.1) | 7 (9.3) | 2 (14.3) | 0.628 | 7 (9.6) | 2 (12.5) | 0.662 |
Qualitative variables are shown as number (percentages) and continuous variables as median [quartile 1-quartile 3]
ICU intensive care unit, NSTI necrotizing soft tissue infection
adefined by one of the following: a duration of hospital stay ≥ 6 weeks, a number of debridement performed ≥ 3, or hospital death
Bolded variables are significant at the p < 0.05 level