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Hyperbaric Oxygen Therapy for Necrotizing Soft Tissue Infections: a Transatlantic Story
*Ali Y Mejaddam1, *Poya Ghorbani2, *Louis Riddez2, *Daniel Yeh1, *Marc A de Moya1, George C Velmahos1
1Massachusetts General Hospital, Boston, MA;2Karolinska University Hospital, Stockholm, Sweden

OBJECTIVE: To evaluate if hyperbaric oxygen therapy (HBO) as an adjunctive treatment of necrotizing soft tissue infections (NSTI) is associated with improved survival.
DESIGN: Retrospective cohort study.
SETTING: Two academic tertiary medical centers: one center used HBO therapy routinely for NSTIs (Sweden) while the other center did not use it (United States).
PATIENTS: Of 134 patients with a diagnosis of NSTI (01/2007-09/2011), 83 Swedish patients received HBO therapy (HBO group) while the remaining 51 U.S. patients underwent traditional management alone (non-HBO group).
MAIN OUTCOME MEASURES: The primary outcome was survival to hospital discharge. Number of debridements and limb salvage were secondary outcomes.
RESULTS: The two groups were similar in demographics, Charlson Comorbidity Index score, physiologic compromise, leukocytosis, and time to surgery. Non-HBO patients had a higher BMI (34 kg/m2 vs. 28 kg/m2; p=0.006) and rate of diabetes (51% vs. 27%; p=0.004).
OutcomesHBO group (N= 83)Non-HBO group (N= 51)p-value
Amputations1 (2%)7 (19%)0.005
Debridements2.5 + 1.83.4 + 2.70.04
Survival2 (97.5%)7 (86%)0.03

By accounting for differences between the groups, logistic regression identified HBO therapy as an independent predictor of survival (OR: 5.7, 95% CI: 1.1-29.9, p=0.038).
CONCLUSIONS: HBO therapy was associated with improved survival, fewer debridements, and increased rate of limb salvage in patients with NSTI.


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IMPORTANT DATES
Abstract Submission Deadline:
May 5, 2014

Housing Deadline:
August 13, 2014

Early Bird Registration Deadline:
August 11, 2014
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