PD1056 - NUTRITIONAL MANAGEMENT IN PATIENTS WITH NECROTIZING FASCIITIS: A SINGLE-CENTER RETROSPECTIVE STUDY

PD1056

NUTRITIONAL MANAGEMENT IN PATIENTS WITH NECROTIZING FASCIITIS: A SINGLE-CENTER RETROSPECTIVE STUDY

M. Inazuka^1,*, A. Naganuma², S. Oikawa³, N. Yamai⁴, K. Ichikawa¹, A. Kumagai¹, K. Ito¹, T. Ito¹, S. Hoshino¹, H. Aoki¹, N. Itagaki⁵, Y. Miyamae⁶, H. Ogihara⁷, M. Inagawa⁸, T. Tanaka⁹, T. Ogawa⁶

¹Department of Nutrition Management, ²Department of Gastroenterology, ³Department of Pharmacy, ⁴Department of Clinical Laboratory, ⁵Department of Nursing, ⁶Department of Surgery, ⁷Department of Rehabilitation, ⁸Department of Dental and Oral Surgery, ⁹Department of Palliative Care, NHO Takasaki General Medical Center, Takasaki, Japan

Rationale: Necrotizing fasciitis (NF) is a life-threatening infection requiring repeated debridement and prolonged hospitalization, yet reports on nutritional management are scarce. This study investigated nutritional status at admission and the impact of nutritional initiation timing on clinical outcomes.

Methods: This retrospective cohort study included 21 consecutive NF patients admitted to an acute care hospital in Japan between 2022 and 2025. We analyzed admission serum albumin (ALB), prealbumin (PA), time to nutritional initiation (enteral or oral), weight change, length of stay (LOS), and nutrition support team (NST) involvement. Spearman rank correlation and Mann–Whitney U test were used, with p < 0.05 considered significant.

Results: Median age was 52 years (IQR 46–64); 16/21 were male; survival rate was 100%. Median admission ALB was 2.4 g/dL (IQR 2.1–3.2), with 95% (20/21) presenting hypoalbuminemia (ALB < 3.5 g/dL). Median initial PA was 11.9 mg/dL (n=13). Median time to nutritional initiation was 28 hours (IQR 22–66). Patients initiating nutrition within 48 hours (n=14) had significantly shorter LOS than those starting after 48 hours (n=6) (median 45 [IQR 37–53] vs. 92 [55–142] days; p=0.035). Time to initiation correlated positively with LOS (rs=0.4, p=0.080) and admission SOFA scores (rs=0.57, p=0.010), suggesting delayed initiation in more severe cases. NST was involved in 15/21 cases; the NST-involved group showed significantly greater weight loss (median −9.5% vs. 0.0%; p=0.014), reflecting prioritized referral of severe cases.

Conclusion: Low admission ALB in NF patients primarily reflects acute inflammation rather than baseline nutritional status. Nutrition initiated within 48 hours was associated with shorter LOS, though confounding by disease severity must be acknowledged. These findings support early nutritional assessment and multidisciplinary intervention in NF management.

Disclosure of Interest: None declared