Introduction: Necrotizing fasciitis (NF) is a rapidly progressive, life-threatening soft tissue infection characterized by necrosis of the fascia and subcutaneous tissues, with high rates of amputation and mortality. Early diagnosis and aggressive surgical intervention are critical determinants of outcome, yet data from eastern India remain scarce. This study aimed to describe the clinicopathological profile of NF and evaluate factors associated with poor outcomes in patients admitted to a tertiary care center in Jharkhand. Methods: This hospital-based observational study was conducted in the Department of General Surgery, Tata Main Hospital, Jamshedpur, from November 2020 to March 2022. One hundred consecutive patients diagnosed with NF were enrolled. Demographic data, clinical features, microbiological findings, and surgical management were recorded using a predesigned proforma. In-hospital mortality was used as the surrogate for poor outcomes. The chi-square test was used to assess associations between clinical variables and mortality, with p<0.05 considered statistically significant. Results: The mean age of participants was in the 41-60-year group, with a male preponderance (76%). Diabetes mellitus was the most common comorbidity (66%). The lower extremity was the most frequently affected site (75%). Staphylococcus species (29%) and Escherichia coli (25%) were the predominant isolates. Debridement was performed in 97% of patients, and amputation was required in 18%. In-hospital mortality was 14%. On statistical analysis, diabetes mellitus (p=0.022), delayed or absent debridement (p=0.008), requirement of multiple surgeries (p=0.002), and amputation (p=0.009) were significantly associated with poor outcome. Conclusion: Diabetes mellitus, delayed or absent debridement, requirement of multiple operative sittings, and amputation were significantly associated with in-hospital mortality in NF. Early clinical recognition and prompt aggressive surgical intervention, with meticulous management of diabetes, are essential to improve outcomes in this life-threatening condition.
Kumar et al. (Thu,) studied this question.