INVESTIGATION OF PROGNOSTIC INDICATORS FOR NECROTIZING FASCIITIS CARE AND PROGNOSIS

Abstract

Background
Necrotizing fasciitis (NF) is a severe soft tissue infection characterized by rapid progression, high morbidity, and mortality. Early diagnosis and intervention play a crucial role in improving patient outcomes. Several prognostic indicators, including the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score, comorbid conditions, and microbiological profiles, influence disease severity and treatment strategies. This study aims to assess the clinical predictors, microbiological spectrum, and surgical outcomes in NF patients.
Materials & Methods
This prospective analytical study was conducted in the Department of General Surgery, Meenakshi Medical College Hospital, from January to June 2024. Fifty patients diagnosed with NF were included. Clinical and laboratory parameters, including the LRINEC score, were evaluated. Patients underwent debridement or amputation based on disease severity. Pus cultures determined microbial patterns, and patient outcomes were assessed based on risk stratification, surgical intervention, and comorbidities.
Results
Among the 50 patients, 70% had diabetes mellitus, highlighting its strong association with NF. The LRINEC score was a significant prognostic tool, with patients scoring >8 showing higher morbidity (64.2%) and mortality (21.4%). Monomicrobial infections (56%) were more common than polymicrobial infections (26%), with Staphylococci (18%) and E. coli (14%) being the predominant pathogens. Debridement was the most frequently performed surgical intervention (88%), with 68.1% of these patients recovering without complications. However, amputation (12%) was associated with a higher mortality rate (33.3%).
Conclusion
Early diagnosis using the LRINEC score, timely surgical debridement, and targeted antibiotic therapy are critical for improving NF outcomes. Diabetes and elevated LRINEC scores were strong predictors of complications. Prompt intervention significantly reduced the need for amputation and improved survival rates.