Biochemical analysis of soft tissue infectious fluids and its diagnostic value in necrotizing soft tissue infections: a 5-year cohort study
Authors' conclusion
Biochemical analysis and EBF criteria demonstrated diagnostic performances ranging from acceptable to outstanding for NSTI when analyzing soft tissue infectious fluid.
Study context
- Population
- Adults with clinical suspicion of necrotizing soft tissue infections (NSTI) in the limbs who underwent successful ultrasound-guided aspiration of soft tissue infectious fluid, April 2019 to April 202410 abscesses excluded
- Participants
- 72 adults
- Comparison
- NSTI vs Non-necrotizing SSTI
- NSTIn = 39
- Non-necrotizing SSTIn = 23reference
- Outcome
- Diagnostic value of soft tissue infectious fluid biochemical analysis in distinguishing NSTI from non-necrotizing SSTI
Methodological detailsprospective and retrospective cohort, ultrasound-guided aspiration
- Prospective and retrospective cohort
- Ultrasound-guided aspiration
Performance
As reported in the abstract
Discrimination of NSTI (AUC)
- Lactate dehydrogenase (LDH) AUC (outstanding), p < 0.001
- 0.955
- Albumin AUC (excellent), p < 0.001
- 0.884
- Lactate AUC (excellent), p < 0.001
- 0.891
- Total protein AUC (excellent), p < 0.001
- 0.883
- Glucose AUC (acceptable), p < 0.001
- 0.774
- pH AUC (acceptable), p < 0.001
- 0.780
- Light's criteria total score AUC (outstanding), p < 0.001
- 0.925
- Fluid-to-serum LDH ratio AUC (outstanding), p < 0.001
- 0.929
- Fluid-to-serum total protein ratio AUC (outstanding), p < 0.001
- 0.927
Further findings
Fluid biochemical levels
- Significantly higher albumin, lactate, LDH and total protein, and significantly lower glucose and pH, in NSTI vs non-necrotizing SSTI
Original publication
Biochemical analysis of soft tissue infectious fluids and its diagnostic value in necrotizing soft tissue infections: a 5-year cohort study. Crit Care. Published 1 November 2024. doi:10.
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