Necrotizing fasciitis epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]

Overview

The incidence of necrotizing fasciitis in adults is 0.40 cases per 100,000 people/year and the incidence in children is higher at 0.08 cases per 100,000 people/year.The overall mortality rate in the United states from 2003- 2013 was 4.8/1,000,000 per year. Patients from all age groups can develop necrotizing fasciitis but slightly more common among >50 years age and effects men and women equally.The incidence rate of necrotizing fasciitis is high in black, Hispanic, and American Indian individuals compared to Whites and low in Asian individuals.

Epidemiology and Demographics

Incidence

  • Since 2010, on average, there are between 700-1100 cases of necrotizing fasciitis caused by group A streptococcus annually in the United States.[1]
  • The incidence of necrotizing fasciitis in adults is approximately 0.40 per 100,000 individuals. The incidence of necrotizing fasciitis in children is approximately 0.08 per 100,000 individuals.[2][3]

Mortality Rate

  • Early intervention remains the only method of reducing mortality and morbidity in necrotizing fasciitis patients.
  • The overall mortality rate of necrotizing fasciitis related deaths in the United States from 2003-2013 was 4.8/1,000,000 per year.[4]
  • The mortality rate in necrotizing fasciitis is approximately between 24-34%.[5][6]
  • The mortality rate of necrotizing fasciitis increases from 9% to 63% if associated with mysositis and streptococcal toxic shock syndrome.
Types Mortality
Type 1 Variable, depends on underlying comorbidities
Type 2 >32% depends on associated myositis or toxic shock
Type 3 30- 40%
Type 4 >47% (higher if immunocompromised)

Age

Patients of all age groups may develop necrotizing fasciitis, however, it is slightly more common among patients >50 years age.[7]

Gender

Necrotizing fasciitis effects men and women equally.[8]

Race

  • The incidence rate of necrotizing fasciitis is higher in Black, Hispanic, and American Indian individuals compared to Whites.[4]
  • The incidence rate is low in Asian populations.

Developing Countries

Necrotizing fasciitis is more common in developing countries because of low socioeconomic status and poor standards of hygiene.[8]

References

  1. Centers for Disease Control and Prevention (2016)http://www.cdc.gov/features/necrotizingfasciitis/ Accessed on september 6, 2016
  2. File TM, Tan JS, DiPersio JR (1998). "Group A streptococcal necrotizing fasciitis. Diagnosing and treating the "flesh-eating bacteria syndrome"". Cleve Clin J Med. 65 (5): 241–9. PMID 9599907.
  3. Chaouat Y, Chaouat D (1988). "[Primary hyperparathyroidism. History]". Rev Rhum Mal Osteoartic. 55 (7): 475–8. PMID 3051309.
  4. 4.0 4.1 Arif N, Yousfi S, Vinnard C (2016). "Deaths from necrotizing fasciitis in the United States, 2003-2013". Epidemiol Infect. 144 (6): 1338–44. doi:10.1017/S0950268815002745. PMID 26548496.
  5. Ryter A, Hirota Y, Jacob F (1968). "DNA-membrane complex and nuclear segregation in bacteria". Cold Spring Harb Symp Quant Biol. 33: 669–76. PMID 4977757.
  6. McHenry CR, Piotrowski JJ, Petrinic D, Malangoni MA (1995). "Determinants of mortality for necrotizing soft-tissue infections". Ann Surg. 221 (5): 558–63, discussion 563-5. PMC 1234638. PMID 7748037.
  7. Machado, Norman Oneil. "Necrotizing fasciitis: The importance of early diagnosis, prompt surgical debridement and adjuvant therapy." North Am J Med Sci 3 (2011): 107-118.
  8. 8.0 8.1 Sadasivan J, Maroju NK, Balasubramaniam A (2013). "Necrotizing fasciitis". Indian J Plast Surg. 46 (3): 472–8. doi:10.4103/0970-0358.121978. PMC 3897089. PMID 24459334.

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