ABSTRACT
Background: Necrotizing fasciitis refers to the rapidly progressive inflammation of the fascia, with secondary necrosis of subcutaneous tissues. Due to the high mortality, it is considered a surgical emergency, needing timely diagnosis and appropriate treatment with early debridement. The aim of the study was to analyse the clinical profile of patients with necrotizing fasciitis so as to determine the mortality and the risk factors associated with mortality and other poor outcomes.Methods: This retrospective cross-sectional study was conducted in a tertiary hospital in Kerala, from January 2016 through January 2018. 175 cases were identified through the ICD codes for necrotizing fasciitis and Fournier’s gangrene in the discharge and death registers; and data were obtained about these patients. The data were analyzed to assess the study objectives.Results: In this study mortality was found to be 22.7%. Diabetes mellitus was found to be the most common co-morbid disease and had a significant association with increased risk of amputation. Mixed growth (type I NF) was the most common microbiological isolate and Pseudomonas was the most common gram-negative isolate. 4 cases of MRSA were recorded. Klebsiella infection was found to have increased risk of undergoing limb amputation. 7.4% of the patients required amputation during hospital stay for infection control.Conclusions: Necrotizing fasciitis has a high mortality. Diabetes mellitus was found to be the most common co-morbid disease. Increased blood glucose and low serum albumin had a significant association with an increased risk of amputation. Proper control of these factors is essential to reduce mortality from this condition.
ABSTRACT
Background: Cancers remain a major cause of morbidity and mortality all over the world. In all major institutions,admissions due to cancers contribute to a large percentage of the inpatient deaths. The objectives of the study were to find out the pattern of deaths caused by cancers in a tertiary level care hospital over a 5 year period and also to find the admission pattern of cancers at the institution. Methods: This was a retrospective study, conducted on patients admitted to all the wards of Government Medical College, Trivandrum, over a 5 year period. The medical records of patients admitted with various cancers were analyzed and the corresponding mortality data were collected. Results: Of the 1545 deaths due to cancers over this 5 year period, the maximum deaths were seen in patients with cancer of the lung, followed by the liver, stomach and breast. In males, cancers of lung, larynx and stomach formed the major bulk of admissions while in the females, breast, ovary and rectum were the most common sites. Conclusion: As per the present study, it is concluded that cancer of the lung forms the major bulk of deaths from cancers in both genders in our institution. Cancer of lung in males and breast in females form the major bulk of morbidity in our population. It is very important to audit mortality data on a regular basis as this can have implications on cancer epidemiology reporting and may positively lead to changes in health policies by the governments