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

Abstract Purpose: Necrotising soft tissue infection (NSTI) is a deadly disease associated with a sig nificant 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. Meth ods: This was a retrospective studyof 45,913 patients in the Nationwide Inpatient Sample (NIS) from 1988 to2009. 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 con founders, patients who received HBO2 therapy had a statistically sig nificantly lower risk of dying (odds ratio (OR) 0.49, 95 % confidence interval (CI) 0.29–0.83), higher hos pitalisation cost (US$52,205 vs. US$45,464, p = 0.02) and longerlength of stay (LOS) (14.3 days vs. 10.7 days, p.001). Conclu sions: This retrospective analysis of HBO2 therapy in NSTI showed that despite the higher hospitalisation costand longer length of stay, the statis tically significant reduction in mortality supports the use of HBO2 therapy in NSTI.