Abstract
Necrotizing fasciitis is a life and limb threatening soft tissue infection with a high mortality rate. This study tries to identify the possible risk factors that contribute to mortality in patients with necrotizing fasciitis involving a lower limb. We prospectively reviewed 41 patients that presented with necrotizing fasciitis of the lower limb over a period of one year. Results show that the mortality rate for necrotizing fasciitis of the lower limb is quite high at 19.5. Comparison among necrotizing fasciitis patientsreveals that higher mortality rate is seen among those patients with advanced age and those presented with initial high pre-operative creatinine levels. Sex, pre-morbid diabetes mellitus, duration from initial symptoms to presentation for treatment and presence of streptococcus group A were not associated with an increased mortality rate. Neither were admission vital signs, subcutaneous gas on radiograph, prior antibiotic treatment on admission or clinical note of bullae formation.
Highlights
Surgical treatment of scoliosis is indicated for patients with curvature more than fifty degrees 1
When comparing the Pain Domain of Scoliosis Research Society 24 (SRS-24) and Scoliosis Research Society 22 (SRS-22), question 1,2,6 and 8 in SRS 24 were present in the same domain in SRS-22, but question 3 and 11 in the SRS 24 questionnaire have been moved to the self image domain in the SRS-22 questionnaire
We found significant differences between the overall score, the pain domain and the self image domain of the SRS-22 and SRS-24 questionnaires
Summary
Surgical treatment of scoliosis is indicated for patients with curvature more than fifty degrees 1. Questionnaires to evaluate functional and psychosocial outcome for spine related conditions are aplenty but Haher et al pioneered a disease specific, health-related quality of life questionnaire for scoliosis patients which was popularly known later as the Scoliosis Research Society 24 (SRS-24) questionnaire 2. It is simple and widely accepted, there were some weaknesses of the questionnaire. Asher et al note that there is a lack of internal consistency in the function domain, unknown test-retest reliability and Besides the Mental Health domain, other domains in the SRS 22 questionnaire were present in the SRS 24 questionnaire; Pain, Self Image, Function, and Satisfaction. Question 18 in the pain domain of SRS-24 has been omitted from SRS-22
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