Predictive value of disease prognosis by three critical blood biochemical indicators in limb necrotizing fasciitis
Sun Fatong1, Li Xiaoyan2, Zhao Jian1, Gao Zhaopeng2, Zhang Xu2, Lyu Lin1, Wang Haibin2, Jia Dailiang1,2
1College of Clinical Medicine, Jining Medical University, Jining 272013, China; 2Emergency Surgery, Affiliated Hospital of Jining Medical University, Jining 272029, China
Abstract：ObjectiveTo explore the predictive value of WBC, Creactive protein (CRP) and serum creatinine (Scr) on the prognosis of the limb necrotizing fasciitis (NF). MethodsThe clinical data and WBC, CRP, Scr detection data of 35 patients with limb NF who where treated in the Department of Emergency Surgery in Affiliated Hospital of Jining Medical University from January 2012 to March 2021 were retrospectively analyzed. According to the prognosis of patients, they were divided into survival group (n=22) and death group (n=13). The general situation and laboratory examination indexes of patients in the two groups were subjected to univariate analysis, and the independent factors impacting the prognosis of NF patients were investigated by using a Logistic regression model with statistically significant variables. The value of different indexes in predicting the prognosis of NF was analyzed by receiver operating characteristic (ROC) curve. ResultsAmong 35 patients , 13 died and 22 survived, with a case fatality rate of 37.14%. In the indexes of sex, age, red blood cell (RBC), platelet (PLT), procalcitonin (PCT), hemoglobin (HB), WBC, CRP and Scr, only WBC count ［（12.53±3.76）×109/L, （20.69±7.83）×109/L］, CRP levels［（112.99±20.34）mg/L, （152.81±47.35）mg/L］ and Scr levels ［（97.19±20.19）μmol/L, （136.81±40.53）μmol/L］ were significantly different （t＝3.53,2.88，3.29, all P＜0.05）between the survival and death group, respectively. Further Logistic regression analysis showed high levels of WBC (OR=0.706, 95%CI: 0.505-0.987), CRP (OR=0.953,95%CI: 0.911-0.997) and Scr (OR=0.953, 95%CI: 0.909-0.999) were all independent factors affecting the poor prognosis of NF patients. The areas under the ROC curve predicted by WBC， CRP and Scr were 0.881 (95%CI: 0.773-0.990, P＜0.01), 0.776 (95%CI: 0.596-0.956, P＜0.01), 0.790 (95%CI: 0.608-0.973, P＜0.01), and the combined AUC was 0.951 (95%CI: 0.875-0.996, P＜0.01). ConclusionWBC, CRP and Scr are independent factors affecting the prognosis of NF patients, and can be used as blood biochemical indexes to evaluate the prognosis of patients with NF.
