Management Outcome and Associated Factors of Necrotizing Soft Tissue Infections in an Ethiopian Tertiary Care Hospital: A-Five-Year Review.

Abstract

Background: Necrotizing soft tissue infection (NSTI) is one of the deadliest diseases among surgical infections. Prompt timely diagnosis and urgent surgical intervention with supportive care are cornerstones of patient management. This study aimed to assess patient outcomes and associated factors of adult patients diagnosed and surgically treated for NSTIs at Saint Paul's Hospital Millennium Medical College (SPHMMC), Ethiopia from January 2015 to December 2019.

Method: An institution-based cross-sectional study was conducted by reviewing medical records of patients treated for NSTIs at SPHMMC in the 5 years study period. A five-section survey instrument was developed, and the collected responses were cleaned and entered into Epi data (v3.1) and exported to SPSS (v.26). Statistical analysis of associated factors was done with binary logit regression model.

Result: Medical records of 110(84%) patients were retrieved and nine out of ten subjects were male with a median age of 42 years (IQR- 34-62yrs) The leading clinical presentations were painful swelling 96(87.3%), fever 79(71.8%) and foul-smelling discharge 62(56.4%). Five out of ten participants have known comorbidity and 9 out of 10 patients have specified predisposing events before their infection. The majority (86.3%) underwent surgical debridement and amputation was done for eighteen patients. The average length of hospital stay was 27 days (2 to 112 days range) with mortality rate of 20%. advanced age, shock at presentation, post-operative anemia, and infection involving the torso were significantly associated with poor patient outcomes.

Conclusion: Surgical management of NSTIs has favorable result and patient presentation and anatomical location of the lesion determine patient outcome.