A comparative study of necrotising fasciitis in patients with and without type 2 diabetes mellitus

Abstract

Background: Sparse published data are available comparing necrotising fasciitis (NF) in patients with and without type 2 diabetes mellitus (T2DM). Methods: Consecutive patients presenting with NF to our tertiary care teaching institute in Tirupati from March 2021 to June 2022 (n = 100; with T2DM [n = 60], without T2DM [n = 40]) were prospectively studied. The predisposing factors, clinical presentation, performance of laboratory risk indicator for necrotising fasciitis (LRINEC) score and its association with inhospital outcome of NF were compared in patients with and without T2DM. Results: In NF patients with or without T2DM, mean age (58.3 ± 11.0 Vs 55.3 ± 15.5 years; P = 0.22), gender distribution (M: F = 42:18 Vs 29:11; P = 0.787), history of trauma (50% Vs 45%; P = 0.787) and site of involvement (right lower limb 45% Vs. 35%; P = 0.813) were similar. A significantly higher proportion of patients with T2DM had chronic kidney disease (6/60 Vs 11/40; P = 0.02) and corticosteroid use (8/60 Vs 4/40; P = 0.04) compared to those without T2DM. The mean LRINEC score was similar in patients with and without T2DM (7.3 ± 2.5 Vs 6.8 ± 3.0; P = 0.9). The mean duration of intensive care unit stay (days) (4.4 ± 4.0 Vs 3.3 ± 2.4; P = 0.12), amputation rates (13.3% Vs 10%; P = 0.615) and mortality (25% Vs 22.5%; P = 0.774) were similar in NF patients with and without T2DM. Conclusions: Our observations suggest that predisposing factors, clinical presentation and outcomes were similar in NF patients with and without T2DM.

Keywords

• lrinec score
• necrotising fasciitis
• type 2 diabetes mellitus