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Necrotising fasciitis deaths in Australia: patient characteristics and potential areas for improvement in clinical management
- Source :
- ANZ Journal of Surgery. 90:2329-2333
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
Abstract
- Background: Necrotising fasciitis (NF) is a life-threatening bacterial infection with high mortality. This retrospective study aimed to investigate patient characteristics and potential areas for improvement in clinical management in NF cases in Australia. Methods Retrospective analysis of surgical death data from all public and private Australian hospitals in every state and territory, excluding New South Wales, collected through the Australian and New Zealand Audit of Surgical Mortality for the 9-year period, January 2009 to February 2018. Results A total of 290 NF cases were identified. Among these NF cases, obesity and diabetes mellitus were two of the most common comorbidities, with a prevalence of 26% and 41%, respectively. A total of 41 clinical management issues (CMIs) were identified among 36 NF cases. A larger proportion of NF cases had CMIs compared with non-NF surgical mortality cases. Delay in diagnosis was the leading CMI (n= 28, 68.3%), followed by delay to surgery (n= 7, 17.1%). The majority of delayed diagnoses were attributed to non-surgical clinicians in the hospital. Conclusion CMIs were identified in a larger proportion of NF cases than in other non-NF surgical mortality cases, suggesting that there are areas for improvement in NF diagnosis and management in Australia. The leading potentially avoidable issue identified in NF deaths was delay in diagnosis. This highlights the importance of awareness among non-surgical clinicians that NF is a surgical emergency requiring urgent debridement. Refereed/Peer-reviewed
- Subjects :
- medicine.medical_specialty
surgical education
Necrotising fasciitis
Patient characteristics
030230 surgery
03 medical and health sciences
0302 clinical medicine
Internal medicine
Diabetes mellitus
Health care
medicine
Humans
plastic and reconstructive surgery
Fasciitis, Necrotizing
Surgical emergency
delayed diagnosis
Medical diagnosis
Retrospective Studies
business.industry
Australia
necrotisingfasciitis
Retrospective cohort study
General Medicine
medicine.disease
health care
Obesity
Debridement
030220 oncology & carcinogenesis
Surgery
New South Wales
business
New Zealand
Subjects
Details
- ISSN :
- 14452197 and 14451433
- Volume :
- 90
- Database :
- OpenAIRE
- Journal :
- ANZ Journal of Surgery
- Accession number :
- edsair.doi.dedup.....3031ac673dd7d069421d09f579f80185