Necrotizing soft tissue infections in critically ill neutropenic patients: a French multicentre retrospective cohort study
Authors' conclusion
Critically ill neutropenic patients with NSTIs present different clinical and microbiological characteristics and are associated with a higher hospital mortality than non-neutropenic patients. G-CSF administration was associated with hospital survival.
Study context
- Population
- Critically ill patients admitted with necrotizing soft tissue infections (NSTIs) in 18 French intensive care units (ICUs), 2011–202118 ICUs
- Participants
- 76 vs 165
- Exposure
- Neutropenic vs non-neutropenic patients with NSTIs
- Neutropenicn = 76
- Non-neutropenicn = 165reference
- Outcome
- In-hospital mortality
Methodological detailsmulticentre, propensity score matching, Cox regression
- Multicentre
- Propensity score matching
- Cox regression
Main finding
As reported in the abstract
P < 0.001
Observational data: associations, not effects.
Further findings
Age
P = 0.002
Lower limb NSTIs
P < 0.001
Abdomino-perineal NSTIs
P < 0.001
| Outcome | Estimate | P value | |
|---|---|---|---|
| In-hospital mortality with G-CSF administration (neutropenic patients)G-CSF vs No G-CSF · univariable Cox | HR 0.43 (95% CI 0.23–0.82) | P = 0.010 | |
| In-hospital mortality with G-CSF administration (neutropenic patients)G-CSF vs No G-CSF · multivariable Cox | aHR 0.46 (95% CI 0.22–0.94) | P = 0.033 | |
| In-hospital mortality with G-CSF administration (neutropenic patients)G-CSF vs No G-CSF · overlap propensity score weighting | OR 0.25 (95% CI 0.09–0.68) | P = 0.006 | |
| 0.050.21520Ratio (log scale) |
Microbiology (neutropenic patients)
- Enterobacterales and non-fermenting gram-negative bacteria most frequently isolated
Original publication
Necrotizing soft tissue infections in critically ill neutropenic patients: a French multicentre retrospective cohort study. Ann Intensive Care. Published 28 April 2023. doi:10.
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