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The following is a summary of “A comparison of outcomes between transferred patients versus patients who presented directly to the emergency department with necrotizing fasciitis,” published in the March 2025 issue of International Journal of Emergency Medicine by Neeki et al. 

Researchers conducted a retrospective study to examine outcomes for individuals with necrotizing fasciitis (NF) treated at facilities without surgical support.  

They performed a 10-year study analyzing emergency department (ED) documentation and surgical reports of individuals treated at Arrowhead Regional Medical Center from January 1, 2011, to December 31, 2020 and 2 groups were identified: the Transfer Group (TG) for those transferred from another facility and the Direct Admit Group (DAG) for those who arrived directly at the ED. A comparison assessed statistical differences in final NF diagnoses, focusing on mortality rate, hospital length of stay (LOS), and intensive care unit (ICU) LOS.  

The results showed that 134 individuals with confirmed NF were included in the final analysis. More than half (50.8%, n = 68) were transferred from area hospitals. The TG had a significantly higher rate of surgical intervention within 6 hours of ED arrival compared to the DAG (95.6% vs 10.6%; P < 0.0001). Mortality was lower in the TG than in the DAG (11.8% vs 22.7%), though the difference was not statistically significant, and no differences were observed in hospital LOS (13 days vs 13.5 days; P = 0.9046) or ICU LOS (3 days for both; P = 0.4845).  

Investigators concluded that aggressive medical management potentially lessened mortality in NF cases when immediate surgery was impossible. 

Source: intjem.biomedcentral.com/articles/10.1186/s12245-025-00848-w