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Rev. Esp. Cir. Ortop. Traumatol. (Ed. Impr.) ; 61(4): 265-272, jul.-ago. 2017. tab
Article in Spanish | IBECS | ID: ibc-164795

ABSTRACT

Objetivo. Describir la mortalidad y las complicaciones de pacientes atendidos en urgencias, con diagnóstico de infección necrosante de partes blandas (INPB) y su correlación con la escala Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC). Método. Estudio observacional retrospectivo con inclusión de pacientes con diagnóstico de INPB en urgencias de un hospital terciario durante 7 años. Los resultados se muestran como mediana, rango intercuartílico y rango absoluto para las variables cuantitativas. En el caso de las variables cualitativas, como frecuencias absoluta y relativa. La comparación se ha llevado a cabo mediante comparación post-hoc a partir de un análisis ANOVA con aproximación no paramétrica. Las comparaciones entre grupos de LRINEC en las variables cualitativas se han realizado con la prueba exacta de Fisher. Resultados. Se identificaron 24 pacientes con edad media de 51,9 años. La escala LRINEC se determinó en 21 pacientes: en 10 indicó bajo riesgo (<6), en 4 riesgo intermedio (6 o 7) y en 7 alto riesgo (≥8). La tasa de amputación en riesgos bajo, intermedio y alto fue del 10, 25 y 66%, respectivamente, con una mortalidad del 4,2%. Se observa un aumento en la estancia hospitalaria entre los niveles bajo y alto de la escala (p=0,007). Conclusiones. En general no se ha podido constatar un cambio en el pronóstico entre los niveles medio y alto de la escala LRINEC. Pero sí entre la estancia hospitalaria entre el nivel bajo y el alto, triplicando prácticamente la mediana de días de estancia hospitalaria (AU)


Aim. To describe mortality and complications of patients seen in the emergency room, diagnosed with necrotizing soft tissue infection (NSTI) and the correlation of such complications with the Laboratory Risk Indicator for Necrotizing fasciitis scale (LRINEC). Methods. Retrospective observational study including patients with a diagnosis of NSTI in the emergency room of a tertiary hospital over 7 years. The results are shown as median, interquartile range and absolute range for quantitative variables. In the case of qualitative variables, the results are shown as absolute and relative frequency. The comparison between the categories of the LRINEC scale was performed through a post-hoc comparison from a non-parametric ANOVA analysis. Comparisons between LRINEC groups in the qualitative variables were performed using Fisher's Exact test. Results. 24 patients with a mean age of 51.9 years were identified. The LRINEC scale was used on 21 patients: in 10, the value indicated low risk (<6), in 4 it indicated intermediate risk (6 or 7) and in 7 it indicated high risk (≥8). The amputation rate in patients with low, intermediate and high risk was 10%, 25% and 66% respectively with a mortality of 4.2%. There was an increase in hospital stay between the low and high level of the scale (p=0,007). Conclusions. In general, a change in the prognosis between the medium and high levels of the LRINEC scale could not be recorded, but was recorded in hospital stay between the low and the high level, practically tripling the median of days of hospital stay (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Soft Tissue Infections/complications , Soft Tissue Infections/mortality , Soft Tissue Infections/surgery , Amputation, Surgical/instrumentation , Fasciitis, Necrotizing/diagnosis , Decision Support Techniques , Skin Diseases, Infectious/complications , Skin Diseases, Infectious/pathology , Analysis of Variance , Prognosis , Length of Stay/trends , Retrospective Studies , Fasciitis, Necrotizing/complications
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