Impact of liver cirrhosis on morbidity and mortality of patients admitted to the hospital with necrotizing fasciitis

Abstract

Background: Necrotizing fasciitis (NF) is a potentially fatal bacterial infection of the soft tissues. Liver cirrhosis appears to be a contributing factor to higher morbidity and mortality in patients with NF. This research article explores the relationship between these two conditions. Aim: To evaluate whether liver cirrhosis increases morbidity and mortality in patients with NF, focusing on inpatient mortality, septic shock, length of stay, and hospital costs. Methods: This retrospective cohort study utilized data from the Healthcare Cost and Utilization Project 2019 National Inpatient Sample. Cases were identified as patients with both NF and cirrhosis, while controls were non-cirrhotic. The study focused on inpatient mortality as the primary outcome, with secondary outcomes including surgical limb amputation, mechanical ventilation rates, septic shock, length of stay, and hospital costs. Results: A total of 14920 patients were admitted to the hospital for management of NF, of which 2.11% had liver cirrhosis. Inpatient mortality was higher in cirrhotic patients (9.5% vs 3%; adjusted odds ratio = 3.78; P value = 0.02). Cirrhotic patients also had higher rates of septic shock (10.5% vs 4.9%, P value < 0.01). Length of hospital stay, total charges, and rates of mechanical ventilation were not statistically different between groups. Conclusion: Liver cirrhosis is an independent risk factor of in-hospital mortality and morbidity in patients with NF. Clinicians should be aware of this association to ensure better clinical outcomes and spare healthcare expenditure.