Obesity Is Not an Independent Predictor of Necrotizing Soft Tissue Infection Outcomes

Abstract

Background: Necrotizing soft tissue infections (NSTIs) are a group of rapidly progressive infections of the skin and its underlying tissue. These infections result in substantial morbidity and mortality. The focus of this study was to determine if obesity is associated with a worsened clinical outcome or prolonged hospital course for patients with NSTIs. Patients and Methods: We conducted a retrospective chart review of patients with NSTI presenting to a single tertiary hospital. Fat content, measured with body mass index (BMI) and abdominal fat thicknesses, including subcutaneous and visceral fat, were compared against primary and secondary outcomes of NSTIs. Results: We found that women had a higher mortality rate compared with men (27% vs. 15% mortality). Women also had an increased subcutaneous abdominal fat thickness (55.7 vs. 36.9 mm, p = 0.028). However, no measurements of fat, BMI, subcutaneous fat, or visceral fat differed between survivors and mortalities of NSTIs. In fact, with the exception of a higher BMI in those who developed acute kidney injury (AKI, p = 0.034), we found no correlation between increases in fat measurement and secondary outcome, including propensity to develop sepsis during hospitalization, length of hospital stay, length of intensive care stay, or antibiotic usage. Multivariable logistic regression analysis was conducted, and we found no statistically significant differences in primary or secondary outcomes. Conclusion: Women appear to have a higher mortality in NSTI, although the reasons for this are unclear. Obesity, as measured by BMI, subcutaneous, and visceral fat thicknesses, does not appear to be an independent risk factor.

Can scoring systems determine the length of hospital stay in cases of Fournier's gangrene?

“…There is limited data on the relationship between obesity and FG. In a retrospective study comparing normal weight patients with overweight patients (BMI> 25 kg/m2), weight was not found to have an effect on mortality (n=91, p=0.6) (19). In this study, mortality was not observed, and an effect of BMI on hospital stay was not found (p=0.1).…”

“…While age, female gender, and DM are considered as risk factors for mortality, HT and COPD have not been shown to be associated with mortality. (10,15,(17)(18)(19).…”