P-751. A 10-year retrospective review of Necrotizing Fasciitis at a Tertiary Referral Hospital in a Low/Middle Income Country

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Abstract Background Necrotizing fasciitis (NF) is a rare, yet potentially fatal skin and soft tissue infection, with a global annual incidence of 0.3 to 15 per 100,000 cases. Early surgical debridement is crucial as mortality rates can reach up to 76%. there is a notable scarcity of data on the epidemiology of NF in the Eastern Mediterranean region. Our aim is to investigate clinical characteristics and outcomes among patients diagnosed with necrotizing fasciitis in a tertiary referral center in Beirut, Lebanon. Demographic and Clinical Characteristics in the Study Population Methods A retrospective chart review of hospitalized cases between 2011 and 2021. The study population included adult patients diagnosed with NF during this period. Data included demographic and clinical characteristics. Physical Findings Results We identified and included a total of 41 cases of NF in this cohort. The average age of the patients was 54.6 years, with males comprising the majority at 73%. The most prevalent co-morbidity was Diabetes Mellitus (48.78%), followed by hypertension (41.46%), cardiovascular diseases (41.46%), and renal failure (36.59%). Pain (87.80%), erythema (78.80%), and swelling (75.61%) were the most common symptoms. Skin discoloration was present in twenty-four of the forty-one patients (59%). Regarding outcomes, the patients identified were divided in two groups: survivors and deceased. overall mortality rate was 37%, and amputation rate was 10% (Table 3). Patients in both groups underwent a median of 3 surgical debridement’s. Time to diagnosis did not significantly differ between survivors (median 1.75 hours) and non-survivors (median 6 hours), whereas antibiotics were administered with a median time of 30 minutes from diagnosis in the survival group, compared to one hour in the deceased group. Time to surgery showed a 7-hour delay in the deceased group compared to survivors (p=0.096). Timelines and Clinical Outcomes Conclusion To our knowledge, this study represents the first comprehensive review of necrotizing fasciitis (NF) in Lebanon, providing valuable insights into demographics and comorbidities. Our findings reveal a mortality rate of 37%, which is consistent with the ranges reported in existing literature, highlighting the need for continued efforts to improve outcomes for patients with NF in our region. Disclosures All Authors: No reported disclosures

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