SRS148 - A ten year update on necrotising fasciitis at a single tertiary centre: factors influencing survival outcomes

Abstract Objectives This study aimed to evaluate clinical outcomes and predictive factors associated with necrotising fasciitis (NF) in patients referred to a tertiary centre over a 10-year period. Objectives included analysis of mortality rates, prognostic utility of the LRINEC score, and factors influencing management and outcomes for patients presenting with NF. Methods All patients with a confirmed diagnosis of NF from January 2015–March 2025 were identified through a retrospective database. Demographic, clinical, and laboratory data were analysed. Mortality predictors were assessed using univariate and stepwise multivariate logistic regression. Associations with LRINEC scores and the presence of Group A Streptococcus were evaluated. Results A total of 87 patients were included with a mean age of 56.5 years; 60.9% were male. Overall mortality was 36.8%, with 23.0% within 30 days. The average time to theatre was 1388.56 min and ICU admission was required in 62.2% of cases, and organ support in 9.8%. In univariate analysis, mortality increased with age (OR 1.059,P < 0.001), organ-support (OR 5.88,P = 0.038), ischaemic heart disease, and chronic kidney disease. Protective factors included ICU admission (OR 0.381,P = 0.047) and longer hospital stay (OR 0.976,P = 0.024). Multivariate analysis confirmed age (OR 1.104,P < 0.001), organ-support (OR 23.6,P = 0.008), immunosuppression (OR 202.1,P = 0.004), and white cell count (OR 0.860, P = 0.008) as independent predictors of mortality. LRINEC score >6 was not independently predictive of mortality. Conclusions NF is associated with high early mortality and ICU burden. Age, immunosuppression, organ support are key mortality predictors. Early recognition and wide margin excision of tissue with ITU support remain critical for patient survival.