Hyperbaric oxygen therapy in necrotising soft tissue infections: a study of patients in the United States Nationwide Inpatient Sample

Purpose

Necrotising soft tissue infection (NSTI) is a deadly disease associated with a significant risk of mortality and long-term disability from limb and tissue loss. The aim of this study was to determine the effect of hyperbaric oxygen (HBO₂) therapy on mortality, complication rate, discharge status/location, hospital length of stay and inflation-adjusted hospitalisation cost in patients with NSTI.

Methods

This was a retrospective study of 45,913 patients in the Nationwide Inpatient Sample (NIS) from 1988 to 2009.

Results

A total of 405 patients received HBO₂ therapy. The patients with NSTI who received HBO₂ therapy had a lower mortality (4.5 vs. 9.4 %, p?=?0.001). After adjusting for predictors and confounders, patients who received HBO₂ therapy had a statistically significantly lower risk of dying (odds ratio (OR) 0.49, 95 % confidence interval (CI) 0.29–0.83), higher hospitalisation cost (US$52,205 vs. US$45,464, p?=?0.02) and longer length of stay (LOS) (14.3?days vs. 10.7?days, p?Conclusions This retrospective analysis of HBO₂ therapy in NSTI showed that despite the higher hospitalisation cost and longer length of stay, the statistically significant reduction in mortality supports the use of HBO₂ therapy in NSTI.