Predicting the mortality of necrotizing fasciitis with blood pressure and white blood cell count

被引:2
|
作者
Fann, Wen-Chih [1 ,2 ]
Chiang, I-Jen [2 ]
Hsiao, Cheng-Ting [1 ,3 ]
Hong, Yu-Cheng [1 ,3 ]
Chen, I-Chuan [1 ,3 ]
机构
[1] Chang Gung Mem Hosp, Dept Emergency Med, Chiayi, Taiwan
[2] Taipei Med Univ, Grad Inst Biomed Informat, Taipei, Taiwan
[3] Chang Gung Univ, Dept Med, Tao Yuan, Taiwan
关键词
decision tree; mortality; necrotizing fasciitis; risk factor; SOFT-TISSUE INFECTIONS; DECISION TREE; RISK-FACTORS; STRATEGIES; MANAGEMENT; CARE;
D O I
10.1111/j.1744-1633.2012.00598.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
Aim Even with modern care, necrotizing fasciitis (NF) is a life-threatening emergency disease. The present study attempts to identify simple clinical admission characteristics or laboratory tests to differentiate between high- and low-mortality risk groups in patients with NF. Patients and Methods The records of 272 patients who received debridement were reviewed. The ? 2-test (or the MannWhitney U-test) and C4.5 decision tree were utilized to analyse 23 clinical characteristics and laboratory tests. The main outcome measure was in-hospital mortality. Results The overall mortality rate was 17 per cent. Three independent predictors of mortality white blood cell (WBC) count; left shift in the differential WBC count, with an increase in immature neutrophils (band form); and hypotension were determined using the C4.5 decision tree. From these predictors, a decision tree was produced to classify patients with NF into high- and low-mortality risk groups. The accuracy of the C4.5 decision tree with cross-validation was 84.2 per cent (95 per cent confidence interval: 80.388.1 per cent). Conclusion Using routine blood pressure measurements and simple laboratory tests of WBC count and differentials, clinicians can rapidly identify patients with high-mortality risk.
引用
收藏
页码:103 / 108
页数:6
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