Retrospective Cohort Study Comparing Outcomes and High-Risk Factors of Patients Presenting with Necrotizing Soft Tissue Infections in Far North Queensland-20 Years of Experience

Abstract

Necrotizing soft tissue infections (NSTIs) are high-morbidity and high-mortality conditions that particularly affect comorbid patients. Previous Australian cohorts had limited numbers of patients within them; however, due to geographical, social and climate factors, North Queensland has significantly higher presentations than most of the country. We have completed a retrospective cohort study between 2002 and 2012 and 2014 and 2024 of patients with ICD codes and documented clinical histories consistent with NSTI who presented to a single tertiary centre. 213 patients were identified. There was a 14% mortality rate, and common comorbidities were diabetes, smoking, high BMI and high ethanol use. Patients were likely to present with vital signs within the normal range and high inflammatory markers. Of the patients, 51% identified as First Nations, an incidence rate 88 times higher than all other ethnicities put together. First Nations patients were younger (51.78 vs. 55.74 years, p = 0.02), had higher rates of diabetes (86% vs. 34%, p ≤ 0.001), shorter times spent in ICU (6.77 days vs. 10.1 days, p = 0.03), higher average time to theatre (57.7 h vs. 35.3 h, p = 0.03) but a comparable mortality rate (13.9% vs. 13.3%, p ≥ 0.99) Conclusions: This study helps us to better understand NSTI in the Australian setting as a basis for further research.