Use of serum lactate and serum sodium at admission to predict mortality in necrotising fasciitis

Abstract

Background: The term necrotizing fasciitis (NF) describes a group of life-threatening infections of the skin, soft tissues, and muscles, which tend to progress rapidly through the fascia planes, causing gradual destruction of the fascia. The mortality rate for NF remains high and has not changed significantly for several decades. The prognosis depends on accurate diagnosis and immediate institution of appropriate treatment.The current difficulty in initial diagnosis is due to the lack of obvious skin findings early on in the infection. Laboratory tests, including the laboratory risk indicator for necrotizing fasciitis, gas on imaging tests, and physical exam findings.Methods: This is a prospective study of 100 patients of necrotising fasciitis. Serum sodium and serum lactate at time of admission were used to predict mortality.Results: Total of 21 patients died. Above Serum lactate value of 2.95mmol/l mortality rate was 48.3%. and below it was 9.9%. Serum sodium was non significant in predicting mortality.Conclusions: The mortality of NF remains high. A simple model using serum lactate at time of admission may help identify patients at greatest risk of death.