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Table 2 Care trajectory in patients with necrotizing soft tissue infections (n = 170) according to immunosuppression and abdomino-perineal location status

From: Healthcare trajectory of critically ill patients with necrotizing soft tissue infections: a multicenter retrospective cohort study using the clinical data warehouse of Greater Paris University Hospitals

 

N

Total

Other locations

Abdomino-perineal NSTIs

P-value

No immunosuppression

Immunosuppression

P-value

N = 170

N = 137

N = 33

N = 127

N = 43

Hospital trajectory data

 Length of ICU stay (days)

170

8 [3–17]

9 [4–17]

5 [2–19]

0.207

8 [4–17]

9 [2–15]

0.500

 Length of hospital stay (days)

170

37 [14–71]

36 [14–69]

39 [16–71]

0.762

39 [16–71]

23 [9–63]

0.070

 Delay admission surgery (days)

168

1 [0 – 2]

1 [0 – 2]

1 [0 – 1]

0.495

1 [0–2]

1 [1–5]

0.004

 Annual NSTI procedural volume

170

   

0.601

  

0.638

   < 3/year

 

38 (22.3)

29 (21.2)

9 (27.3)

 

30 (23.6)

8 (18.6)

 

   ≥ 3/year

 

132 (77.6)

108 (78.8)

24 (72.7)

 

97 (76.4)

35 (81.4)

 

 Inter-hospital transfer

168

   

0.934

  

0.484

  No

 

80 (47.6%)

65 (48.1)

15 (45.5)

 

62 (49.6)

18 (41.9)

 

  Yes

 

88 (52.4%)

70 (51.9)

18 (54.5)

 

63 (50.4)

25 (58.1)

 

 Type of structure after ICU

168

   

0.045

  

0.034

  Medical ward

 

85 (50.6)

74 (54.8)

11 (33.3)

 

58 (46.0)

27 (64.3)

 

  Rehabilitation

 

10 (6.0)

9 (6.7)

1 (3.0)

 

10 (7.9)

0

 

  Plastic surgery

 

16 (9.5)

13 (9.6)

3 (9.1)

 

15 (11.9)

1 (2.4)

 

  Other surgical ward

 

57 (33.9)

39 (28.9)

18 (54.5)

 

43 (34.1)

14 (33.3)

 

Management during hospital course

 Mechanical ventilation

166

86 (51.8)

69 (51.5)

17 (53.1)

0.999

63 (50.8)

23 (54.8)

0.791

 Vasopressor support

167

129 (77.2)

105 (77.8)

24 (75.0)

0.918

97 (77.6)

32 (76.2)

0.999

 Renal replacement therapy

166

46 (27.7)

38 (28.4)

8 (25.0)

0.872

30 (24.2)

16 (38.1)

0.123

 Organ failure

167

134 (80.2)

110 (81.5)

24 (75.0)

0.561

101 (80.0)

34 (81.0)

0.999

 Skin grafting

167

54 (32.3)

46 (34.1)

8 (25.0)

0.437

46 (36.8)

8 (19.0)

0.053

 Skin grafting-first surgery (days)

36

28 [13 – 39]

28 [13 – 39]

29 [18 – 43]

0.999

25 [13 – 38]

34 [31 – 40]

0.348

 Amputation

166

26 (15.7)

24 (17.9)

2 (6.3)

0.174

22 (17.7)

4 (9.5)

0.307

 Negative pressure therapy

167

62 (37.1)

46 (34.3)

16 (48.5)

0.191

51 (40.8)

11 (26.2)

0.131

 Number of additional debridements

166

1 [0–3]

1 [0–3]

3 [1–6]

 < 0.001

2 [0–3]

1 [0–2]

0.041

Outcomes

 ICU Mortality

170

37 (21.8)

30 (21.9)

7 (21.2)

0.999

21 (16.5)

16 (37.2)

0.009

 Complicated hospital coursea

169

123 (72.8)

97 (71.3)

26 (78.8)

0.518

89 (70.6)

34 (79.1)

0.382

  In-hospital mortality

170

49 (28.8)

40 (29.2)

9 (27.3)

0.996

26 (20.5)

23 (53.5)

 < 0.001

  Number of debridements > 3

166

62 (37.3)

18 (13.4)

13 (40.6)

 < 0.001

27 (21.8)

4 (9.5)

0.126

  Hospital stay > 6 weeks

170

156 (91.8)

62 (45.3)

16 (48.5)

0.889

61 (48.0)

17 (39.5)

0.430

 Re-hospitalization within 6 months of ICU discharge

106

66 (62.3)

49 (57.6)

17 (81.0)

0.085

56 (62.9)

10 (58.8)

0.963

 ICU readmission within 6 months

89

9 (10.1)

7 (9.3)

2 (14.3)

0.628

7 (9.6)

2 (12.5)

0.662

  1. Qualitative variables are shown as number (percentages) and continuous variables as median [quartile 1-quartile 3]
  2. ICU intensive care unit, NSTI necrotizing soft tissue infection
  3. adefined by one of the following: a duration of hospital stay ≥ 6 weeks, a number of debridement performed ≥ 3, or hospital death
  4. Bolded variables are significant at the p < 0.05 level