Background: Necrotizing fasciitis, a severe bacterial infection, poses significant health challenges with varied outcomes across different demographic groups. This study examines the gender and racial disparities in the incidence of complications, length of hospital stay, and healthcare costs associated with necrotizing fasciitis, focusing on key outcomes such as mortality, hemodialysis, hospital length of stay, and inflation-adjusted total charges.
Methods: Using data from the National Inpatient Sample from 2016 to 2020, this retrospective study analyzed patients admitted with necrotizing fasciitis. The study categorized patients by gender and race. Multivariate logistic regression was employed to adjust for confounders.
Results: The analysis of 118,774 patients with necrotizing fasciitis revealed notable gender and racial disparities. In terms of gender, females were more likely to require invasive mechanical ventilation (Odds Ratio [OR]: 1.09) and blood transfusion (OR: 1.33), and faced a higher mortality rate (OR: 1.18) compared to males. Asian or Pacific Islanders and Hispanics exhibited higher mortality rates with ORs of 1.49 and 1.16, respectively, compared to White patients. Hemodialysis needs were markedly higher in Asian or Pacific Islanders (OR: 2.87), followed by African Americans (OR: 1.84), Hispanics (OR: 1.35). The length of hospital stay was substantially longer for Asian or Pacific Islanders by 4.24 days, and African American patients by 1.71 days, compared to White patients. In terms of economic impact, Asian or Pacific Islanders faced $17,596.07 higher inflation-adjusted total charges, while African Americans and Hispanics incurred additional charges of $5,899.60 and $4,356.55.
Conclusions: This study reveals significant gender and racial disparities in the clinical outcomes and economic burden of necrotizing fasciitis. Females showed a higher likelihood of severe complications and mortality. Racial disparities were particularly pronounced. These findings underscore the critical need for tailored healthcare strategies to address these disparities and ensure equitable care for all patients with necrotizing fasciitis.