Topic: ESOPRS 2021 ePoster sessions
Time: Sep 17, 2021 16:00 Amsterdam, Berlin, Rome, Stockholm, Vienna, 15:00 London
(plain text version here)
Predictors of Disease Severity and Outcome in Periorbital Necrotizing Fasciitis
Author: Anna Maria Schuh
ePoster Number: 209,00
Purpose
This case series aimed to identify predictors of disease severity in patients with periorbital necrotizing fasciitis (PNF) treated at a single tertiary care center.
Methods
All patients treated for PNF between 2014 and 2024 were included. Demographic and clinical data—including symptom onset, visual acuity, and extent of tissue involvement—were evaluated. The latter was quantified using a scoring system assigning one point for each affected region (upper and lower eyelid, forehead, cheek, and neck). The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score was calculated based on laboratory values at hospital admission. Patient-specific variables were correlated with intensive care unit (ICU) stay duration (< or ≥10 days) and whether radical debridement (RD) was performed. Post-treatment complications, such as eyelid disfigurement and the need for reconstructive surgery, were also assessed.
Results
Twelve patients were included (mean age: 62.3 ± 25.3 years). One patient died from multi-organ failure related to PNF (mortality rate: 8.3%). Older age and higher LRINEC scores were significantly associated with ICU stays exceeding 10 days (age: 45.5 years for <10 days vs. 79.2 years for ≥10 days, p = 0.004; LRINEC: 4.6 vs. 8.3, p = 0.04). Patients undergoing RD had significantly greater tissue involvement preoperatively (score: 2.0 [no RD] vs. 3.8 [RD], p = 0.02). RD was associated with significantly longer ICU stays (3.8 vs. 29.3 days, p = 0.04) and showed a trend toward more long-term complications (17% [no RD] vs. 83% [RD], p = 0.08).
Conclusion
The LRINEC score proved to be a valuable predictor of PNF severity and the need for ICU care. The extent of tissue involvement appeared to be the primary determinant influencing RD decisions.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Lara | Buhl | Augenklinik LMU München |
| Christoph | Hintschich | Augenklinik LMU München |
Abstract ID: 25-422
