Outcomes in necrotizing soft tissue infections treated with therapeutic plasma exchange

• DOI: 10.1111/trf.14067
• Publication Date: 2017-03-07T08:53:02Z
• Authors: Nabiha Huq Saifee; Heather L. Evans; Amalia S. Magaret; John R. Hess; Meghan Delaney; Grant E. O'Keefe; Tam N. Pham; Hugh Foy; Eileen Bulger; Monica B. Pagano
• Keywords: SOFA score

BACKGROUND Treatment of necrotizing soft tissue infections (NSTIs) includes prompt surgical debridement and antibiotics, but despite standard care, the morbidity mortality remain high. Since therapeutic plasma exchange (TPE) has been considered for treatment severe sepsis, this study evaluates efficacy TPE patients with NSTI. STUDY DESIGN AND METHODS This is a retrospective diagnosis NSTI who received without over an 11‐year period. The primary outcome was in‐hospital mortality. RESULTS Fifty‐two treated (TPE group) 125 not (non‐TPE were assessed. Nineteen (36.5%) died in group, 35 (28%) non‐TPE group. Within there significant improvement white blood cell (WBC) count sodium levels 7 days after treatment, no creatinine. Inverse probability weighting based on propensity scores used to compare survival groups demonstrated that associated increased odds death (odds ratio, 2.8). A second analysis matched six variables yielded 31 pairs difference or length stay. CONCLUSIONS describes largest series NSTIs showed evidence clinical benefit. Further carefully designed studies meaningful endpoints would prove useful assessing reproducibility determining if role other forms sepsis.