Objective: To investigate the influencing factors of necrotizing fasciitis (NF)

Methods: Medical records of 782 patients with NF (case group) and perianal abscess (control group) admitted to Nanjing Hospital of Traditional Chinese Medicine from January 2020 to August 2024 were collected. Univariate analysis of baseline and pathological status data and clinical blood and urine test results was performed, and multiple logistic regression was performed to analyze the influencing factors of NF.

Results: In the baseline analysis, the age, alcohol consumption and diabetes ratio in the case group were higher than those in the control group (P<0.05). In terms of pathological status, the incidence of lesions involving perianal and other sites, and the incidence of lesions accompanied by crepitus or skin necrosis, anemia, hypoproteinemia and electrolyte disturbance were higher in case group than in control group (P<0.05). Among the patients undergoing bacterial culture, the positive rates of Gram-positive bacteria infection, enterococcal infection, staphylococcal infection, including Staphylococcus hemolyticus infection and acinetobacter baumannii infection in case group were higher than those in control group (P<0.05), while the positive rates of enterobacter infection were lower than those in control group (P<0.05). In terms of laboratory examination, compared with the control group, the levels of red blood cells, platelets, hemoglobin, lymphocyte percentage, albumin, sodium and potassium were significantly reduced in the case group. The levels of leukocyte, neutrophil percentage, aspartate aminotransferase , UREA, creatinine and glucose were higher than those of control group (P<0.05). Alcohol consumption and elevated white blood cell levels were independent risk factors for NF. 

Conclusion: alcohol, white blood cells increased levels are independent risk factors for the development of necrotizing fasciitis has, this kind of people are at higher risk of NF, so should pay more attention to inspection of this group of people, to avoid the occurrence of NF. The infection of enterococcus, Staphylococcus haemolyticus and Acinetobacter baumannii may also promote the occurrence of NF, so the infection of these pathogens should also be paid attention to in clinic.

Wenzhen Huang received his bachelor's degree in Clinical Medicine of Traditional Chinese and Western Medicine from Chongqing Medical University and is now pursuing his master's degree in Nanjing Hospital of Traditional Chinese Medicine affiliated to Nanjing University of Traditional Chinese Medicine.