Impact of timing of surgery on outcome of Vibrio vulnificus-related necrotizing fasciitis.

doi:10.1016/j.amjsurg.2012.08.008

中山醫學大學機構典藏 CSMUIR > 醫學院 > 醫學系 > 期刊論文 > Item 310902500/17816

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题名:	Impact of timing of surgery on outcome of Vibrio vulnificus-related necrotizing fasciitis.
作者:	WN, Chao CF, Tsai HR, Chang KS, Chan CH, Su YT, Lee KC, Ueng CC, Chen SC, Chen MC, Lee
贡献者:	醫學研究所
关键词:	Vibrio species;Surgical intervention;Necrotic soft tissue infections;Survival
日期:	2013-07
上传时间:	2017-06-27T07:53:32Z (UTC)
出版者:	The American Journal of Surgery
ISSN:	0002-9610
摘要:	Abstract BACKGROUND: The aim of this study was to evaluate the impact of timing of surgery on mortality risk in patients with necrotizing fasciitis (NF) caused by Vibrio vulnificus infection. METHODS: Medical records of 121 patients (mean age, 65.2 ± 11.6 years) with V vulnificus-related NF who underwent surgical intervention between July 1998 and June 2011 were collected and reviewed retrospectively. These patients were divided into 3 groups according to the time between admission and surgical treatment as follows: those who received surgical treatment less than 12 hours after admission, those who received treatment 12 to 24 hours after admission, and those who received treatment more than 24 hours after admission. Cox regression analysis was performed to assess the effect of the timing of surgery after admission on mortality risk across the 3 groups by adjusting for potential confounding covariates. RESULTS: During their hospitalization, 35 patients died, yielding a case-fatality rate of 29%. After adjustment for potential confounding covariates (age, sex, duration of prodrome before admission, severity of illness on admission, the presence of primary septicemia, hepatic disorders, chronic renal insufficiency, blood pressure less than 90/60 mm Hg on admission, surgical and antibiotic modalities, and intensive care needed), patients who underwent surgery less than 12 hours after admission had a significantly lower mortality risk compared with those who had surgery either 12 to 24 hours after admission (adjusted hazard ratio [HR], .064; 95% confidence interval [CI], 1.6 × 10⁻⁷ to .25; P = .037) or more than 24 hours after admission (adjusted HR, .0043; 95% CI, 2.1 × 10⁻⁵ to .0085; P = .002). There was no difference in mortality risk between patients who underwent surgery 12 to 24 hours after admission and those who had surgery more than 24 hours after admission (P = .849). CONCLUSIONS: Our data provide important clinically based evidence for the beneficial effects of surgical treatment within 12 hours of admission for V vulnificus-related NF.
URI:	https://www.doi.org/10.1016/j.amjsurg.2012.08.008 https://ir.csmu.edu.tw:8080/ir/handle/310902500/17816
關聯:	The American Journal of Surgery Volume 206, Issue 1, July 2013, Pages 32-39
显示于类别:	[醫學系] 期刊論文

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