| アブストラクト | Necrotising soft-tissue infections (NSTIs) of the upper limb are uncommon, but potentially life-threatening. We used a national database to investigate the risk factors for amputation of the limb and death. We extracted data from the Japanese Diagnosis Procedure Combination database on 116 patients (79 men and 37 women) who had a NSTI of the upper extremity between 2007 and 2010. The overall in-hospital mortality was 15.5%. Univariate analysis of in-hospital mortality showed that the significant variables were age (p = 0.015), liver dysfunction (p = 0.005), renal dysfunction (P < 0.001), altered consciousness (p = 0.049), and sepsis (p = 0.021). Logistic regression analysis showed that the factors associated with death in hospital were age over 70 years (Odds Ratio (OR) 6.6; 95% confidence interval (CI) 1.5 to 28.2; p = 0.011) and renal dysfunction (OR 15.4; 95% CI 3.8 to 62.8; p < 0.001). Univariate analysis of limb amputation showed that the significant variables were diabetes (p = 0.017) mellitus and sepsis (p = 0.001). Multivariable logistic regression analysis showed that the factors related to limb amputation were sepsis (OR 1.8; 95% CI 1.5 to 24.0; p = 0.013) and diabetes mellitus (OR 1.6; 95% CI 1.1 to 21.1; p = 0.038). For NSTIs of the upper extremity, advanced age and renal dysfunction are both associated with a higher rate of in-hospital mortality. Sepsis and diabetes mellitus are both associated with a higher rate of amputation. |
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| 組織名 | Department of Orthopaedic Surgery, The University of Tokyo, Graduate School of;Medicine, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan.;Department of Clinical Data Management and Research, Clinical Research Center,;National Hospital Organization Headquarters, 2-5-21 Higashigaoka, Meguro-ku,;Tokyo, Japan.;Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School of Medicine 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan. |
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