Variations in Necrotising Soft Tissue infection (NSTI) causative organisms: a five-year retrospective cohort study
Author: Ojas Pandey
Base Hospital / Institution: Hull University Teaching Hospitals
ePoster presentation
Abstract ID: 24-370
Purpose
The aim of this study was to review the rates of necrotising soft tissue infections in Hull and the surrounding area to evaluate and assess whether there has been a surge in Group A Streptococcus (GAS) infections.Secondary outcomes: patient mortality, surgical procedures, and the length of inpatient stay were also measured.
Methods
An inclusion criteria was made which outlined which patients were suitable for the study.1. A diagnosis of necrotising fasciitis between 1st January 2018 until 31st December 2023 2. Must be from the Hull and surrounding Humber region 3. Cannot be managed conservatively (unless palliative)Data was sourced from: daily handover from Jan 2018-Dec 2023, electronic operation records with the operation description “necroti* AND debride*”, and patients admitted to the trust with an ICD10 diagnosis of M72.6 (Necrotising Fasciitis)We also collected data on risk factors for necrotizing fasciitis i.e., being immunocompromised, obese, diabetic, and smoking status (2) and a “subjective assessment of a patient’s overall health” (3) was scored using the ASA scoring system.
Results
A total of 71 patients were analysed, 33 pre-COVID were compared against 38 post-COVID necrotising fasciitis infections.A Chi-squared test found no significant difference in incidence between the groups (p=0.989)The general trend in incidence, showed a dip in incidence during COVID with a gradual rise after itWe used relative risk (RR) to analyse GAS infections compared to non-GAS necrotising infections.RR limb amputation 1.60 (CI 95%: 0.57-0.48)RR 30-day mortality 1.49 (CI 95%: 0.54-4.10)We cannot consider theses results significant as the confidence interval overlaps with 1.
Conclusion
The results show that since the emergence of COVID, there has been no statistical increase in the incidence of necrotising fasciitis caused by GAS. This means that to achieve a large sample size the study should continue to track NSTI in the Hull region as well as include other hospitals. A larger population would mean more data available for analysis and would increase the power of the study
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Joshua | Totty | Hull University Teaching Hospitals |
| James | Haeney | Hull University Teaching Hospitals |
| Hull University Teaching Hospitals |
