Skip to main content
Top
Published in: European Journal of Trauma and Emergency Surgery 6/2022

Open Access 09-06-2022 | Necrotizing Fasciitis | Original Article

Impact of severe necrotizing fasciitis on quality of life in the Netherlands

Authors: Sander F. L. van Stigt, Tim K. J. Schrooten, Merel Knubben, Edward C. T. H. Tan

Published in: European Journal of Trauma and Emergency Surgery | Issue 6/2022

Login to get access

Abstract

Purpose

Necrotizing fasciitis (NF) is a severe soft-tissue infection which can leave survivors with big and multiple disfiguring alterations to their bodies, which can negatively affect the lives of patients by causing functional limitations and altered self-perception. In this study we aim to find if NF affect (self-reported) quality of life (QoL) in patients surviving NF.

Methods

All patients with (histopathological or surgical confirmed) NF who were admitted to the intensive care unit for 24 h or more between January 2003 and December 2017 in five hospitals from the Nijmegen teaching region were included. Quality of life was measured with the SF-36 and WHOQol-BREF. These results were compared to reference populations from the Netherlands and a Australian reference population.

Results

44 out of 60 patients (73.3%) who were contacted returned the surveys and were eligible for analysis. These patients showed lowered levels of quality of life on multiple domains of the SF-36: physical functioning, role limitations due to physical health, vitality and general health. The physical domain of the WHOQol-BREF showed also significant lowered levels of quality of life.

Conclusion

NF is a severe illness with a high morbidity and mortality rate. This study shows that patients who do survive NF have decreased (self-reported) quality of life in multiple domains with a focus on decreased physical functioning. During and after admission realistic expectations should be discussed and there should be more attention to signs of permanent disability. That way extra support by a physiotherapist or social worker can be provided.
Literature
1.
go back to reference Tan JH, Koh BTH, Hong CC, Lim SH, Liang S, Chan GWH, et al. A comparison of necrotising fasciitis in diabetics and non-diabetics a review of 127 patients. Bone Jt J. 2016;98-B(11):1563–8.CrossRef Tan JH, Koh BTH, Hong CC, Lim SH, Liang S, Chan GWH, et al. A comparison of necrotising fasciitis in diabetics and non-diabetics a review of 127 patients. Bone Jt J. 2016;98-B(11):1563–8.CrossRef
2.
go back to reference Van Stigt S, Knubben M, Schrooten T, Tan E. Prognostic factors for mortality in 123 severe cases of necrotizing fasciitis in 5 hospitals in the Netherlands between 2003 and 2017. Eur J Trauma Emerg Surg. 2021;48:1189–95.CrossRefPubMedPubMedCentral Van Stigt S, Knubben M, Schrooten T, Tan E. Prognostic factors for mortality in 123 severe cases of necrotizing fasciitis in 5 hospitals in the Netherlands between 2003 and 2017. Eur J Trauma Emerg Surg. 2021;48:1189–95.CrossRefPubMedPubMedCentral
3.
go back to reference Pham TN, Moore ML, Costa BA, Cuschieri J, Klein MB. Assessment of functional limitation after necrotizing soft tissue infection. J Burn Care Res. 2009;30(2):301–6.CrossRefPubMed Pham TN, Moore ML, Costa BA, Cuschieri J, Klein MB. Assessment of functional limitation after necrotizing soft tissue infection. J Burn Care Res. 2009;30(2):301–6.CrossRefPubMed
4.
go back to reference Goh T, Goh LG, Ang CH, Wong CH. Early diagnosis of necrotizing fasciitis. Br J Surg. 2014;101(1):e119–25.CrossRefPubMed Goh T, Goh LG, Ang CH, Wong CH. Early diagnosis of necrotizing fasciitis. Br J Surg. 2014;101(1):e119–25.CrossRefPubMed
5.
go back to reference Gawaziuk JP, Strazar R, Cristall N, Logsetty S. Factors predicting health-related quality of life following necrotizing fasciitis. J Plast Reconstr Aesthet Surg. 2018;71(6):857–62.CrossRefPubMed Gawaziuk JP, Strazar R, Cristall N, Logsetty S. Factors predicting health-related quality of life following necrotizing fasciitis. J Plast Reconstr Aesthet Surg. 2018;71(6):857–62.CrossRefPubMed
6.
go back to reference Burnett E, Gawaziuk JP, Shek K, Logsetty S. Healthcare resource utilization associated with burns and necrotizing fasciitis. J Burn Care Res. 2017;38:e886–91.CrossRefPubMed Burnett E, Gawaziuk JP, Shek K, Logsetty S. Healthcare resource utilization associated with burns and necrotizing fasciitis. J Burn Care Res. 2017;38:e886–91.CrossRefPubMed
7.
go back to reference Potocka A, Turczyn-Jabłońska K, Kieć-Świerczyńska M. Self-image and quality of life of dermatology patients. Int J Occup Med Environ Health. 2008;21(4):309–17.CrossRefPubMed Potocka A, Turczyn-Jabłońska K, Kieć-Świerczyńska M. Self-image and quality of life of dermatology patients. Int J Occup Med Environ Health. 2008;21(4):309–17.CrossRefPubMed
8.
go back to reference Spronk I, Polinder S, van Loey NEE, van der Vlies CH, Pijpe A, Haagsma JA, et al. Health related quality of life 5–7 years after minor and severe burn injuries: a multicentre cross-sectional study. Burns. 2019;45(6):1291–9.CrossRefPubMed Spronk I, Polinder S, van Loey NEE, van der Vlies CH, Pijpe A, Haagsma JA, et al. Health related quality of life 5–7 years after minor and severe burn injuries: a multicentre cross-sectional study. Burns. 2019;45(6):1291–9.CrossRefPubMed
9.
go back to reference Spronk I, Legemate C, Oen I, van Loey N, Polinder S, van Baar M. Health related quality of life in adults after burn injuries: a systematic review. PLoS ONE. 2018;13(5):e0197507.CrossRefPubMedPubMedCentral Spronk I, Legemate C, Oen I, van Loey N, Polinder S, van Baar M. Health related quality of life in adults after burn injuries: a systematic review. PLoS ONE. 2018;13(5):e0197507.CrossRefPubMedPubMedCentral
10.
go back to reference Spronk I, Legemate CM, Dokter J, van Loey NEE, van Baar ME, Polinder S. Predictors of health-related quality of life after burn injuries: a systematic review. Crit Care. 2018;22(1):160.CrossRefPubMedPubMedCentral Spronk I, Legemate CM, Dokter J, van Loey NEE, van Baar ME, Polinder S. Predictors of health-related quality of life after burn injuries: a systematic review. Crit Care. 2018;22(1):160.CrossRefPubMedPubMedCentral
11.
go back to reference Oh H, Boo S. Assessment of burn-specific health-related quality of life and patient scar status following burn. Burns. 2017;43(7):1479–85.CrossRefPubMed Oh H, Boo S. Assessment of burn-specific health-related quality of life and patient scar status following burn. Burns. 2017;43(7):1479–85.CrossRefPubMed
12.
go back to reference Abrams TE, Ogletree RJ, Ratnapradipa D, Neumeister MW. Adult survivors’ lived experience of burns and post-burn health: a qualitative analysis. Burns. 2016;42(1):152–62.CrossRefPubMed Abrams TE, Ogletree RJ, Ratnapradipa D, Neumeister MW. Adult survivors’ lived experience of burns and post-burn health: a qualitative analysis. Burns. 2016;42(1):152–62.CrossRefPubMed
13.
go back to reference Suijker J, de Vries A, de Jong VM, Schepers T, Ponsen KJ, Halm JA. Health-related quality of life is decreased after necrotizing soft-tissue infections. J Surg Res. 2020;245:516–22.CrossRefPubMed Suijker J, de Vries A, de Jong VM, Schepers T, Ponsen KJ, Halm JA. Health-related quality of life is decreased after necrotizing soft-tissue infections. J Surg Res. 2020;245:516–22.CrossRefPubMed
14.
go back to reference Pikturnaite J, Soldin M. Impact of necrotising fasciitis on quality of life: a qualitative analysis. Burns. 2014;40(5):848–51.CrossRefPubMed Pikturnaite J, Soldin M. Impact of necrotising fasciitis on quality of life: a qualitative analysis. Burns. 2014;40(5):848–51.CrossRefPubMed
15.
go back to reference Czymek R, Kujath P, Bruch HP, Pfeiffer D, Nebrig M, Seehofer D, et al. Treatment, outcome and quality of life after Fournier’s gangrene: a multicentre study. Color Dis. 2013;15(12):1529–36.CrossRef Czymek R, Kujath P, Bruch HP, Pfeiffer D, Nebrig M, Seehofer D, et al. Treatment, outcome and quality of life after Fournier’s gangrene: a multicentre study. Color Dis. 2013;15(12):1529–36.CrossRef
16.
go back to reference Urbina T, Canoui-Poitrine F, Hua C, Layese R, Alves A, Ouedraogo R, et al. Long-term quality of life in necrotizing soft-tissue infection survivors: a monocentric prospective cohort study. Ann Intensive Care. 2021;11(1):102.CrossRefPubMedPubMedCentral Urbina T, Canoui-Poitrine F, Hua C, Layese R, Alves A, Ouedraogo R, et al. Long-term quality of life in necrotizing soft-tissue infection survivors: a monocentric prospective cohort study. Ann Intensive Care. 2021;11(1):102.CrossRefPubMedPubMedCentral
17.
go back to reference Brazier JE, Harper R, Jones NMB, O’Cathain A, Thomas KJ, Usherwood T, et al. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. Br Med J. 1992;305(6846):160–4.CrossRef Brazier JE, Harper R, Jones NMB, O’Cathain A, Thomas KJ, Usherwood T, et al. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. Br Med J. 1992;305(6846):160–4.CrossRef
18.
go back to reference Harper A, Power M, Orley J, Herrman H, Schofield H, Murphy B, et al. Development of the world health organization WHOQOL-BREF quality of life assessment. Psychol Med. 1998;28(3):551–8.CrossRef Harper A, Power M, Orley J, Herrman H, Schofield H, Murphy B, et al. Development of the world health organization WHOQOL-BREF quality of life assessment. Psychol Med. 1998;28(3):551–8.CrossRef
19.
go back to reference Aaronson NK, Muller M, Cohen PDA, Essink-Bot ML, Fekkes M, Sanderman R, et al. Translation, validation, and norming of the Dutch language version of the SF-36 health survey in community and chronic disease populations. J Clin Epidemiol. 1998;51(11):1055–68.CrossRefPubMed Aaronson NK, Muller M, Cohen PDA, Essink-Bot ML, Fekkes M, Sanderman R, et al. Translation, validation, and norming of the Dutch language version of the SF-36 health survey in community and chronic disease populations. J Clin Epidemiol. 1998;51(11):1055–68.CrossRefPubMed
20.
go back to reference Skevington SM, Lotfy M, O’Connell KA. The world health organization’s WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial a report from the WHOQOL group. Qual Life Res. 2004;13(2):299–310.CrossRefPubMed Skevington SM, Lotfy M, O’Connell KA. The world health organization’s WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial a report from the WHOQOL group. Qual Life Res. 2004;13(2):299–310.CrossRefPubMed
21.
go back to reference Hawthorne G, Herrman H, Murphy B. Interpreting the WHOQOL-Brèf: preliminary population norms and effect sizes. Soc Indic Res. 2006;77:37–59.CrossRef Hawthorne G, Herrman H, Murphy B. Interpreting the WHOQOL-Brèf: preliminary population norms and effect sizes. Soc Indic Res. 2006;77:37–59.CrossRef
22.
go back to reference Torrance N, Smith BH, Lee AJ, Aucott L, Cardy A, Bennett MI. Analysing the SF-36 in population-based research. A comparison of methods of statistical approaches using chronic pain as an example. J Eval Clin Pract. 2009;15(2):328–34.CrossRefPubMed Torrance N, Smith BH, Lee AJ, Aucott L, Cardy A, Bennett MI. Analysing the SF-36 in population-based research. A comparison of methods of statistical approaches using chronic pain as an example. J Eval Clin Pract. 2009;15(2):328–34.CrossRefPubMed
Metadata
Title
Impact of severe necrotizing fasciitis on quality of life in the Netherlands
Authors
Sander F. L. van Stigt
Tim K. J. Schrooten
Merel Knubben
Edward C. T. H. Tan
Publication date
09-06-2022
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery / Issue 6/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-022-02011-z

Other articles of this Issue 6/2022

European Journal of Trauma and Emergency Surgery 6/2022 Go to the issue