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The Incidence of Necrotizing Fasciitis in Taiwan: A Nationwide Population-Based Study

Chuang, Kun-Lin, MD*†; Liang, Fu-Wen, PhD; Shieh, Shyh-Jou, MD, PhD; Lu, Tsung-Hsueh, MD, PhD‡∥

doi: 10.1097/SAP.0000000000001298
Research Papers

Background Little is known about the national population-based incidence rates of necrotizing fasciitis (NF) and related epidemiological profiles in Asian countries. We plastic surgeons always face and treat this complicated disease in the first line at the hospital.

Methods Using Taiwan's National Health Insurance inpatient claims data from 2005 through 2010, we investigated the national annual incidence rate of NF by sex, age, year, month, beneficiary category, and region.

Results The overall average annual incidence rate (cases per 100,000 population) of those 6 years of inpatients with NF was 11.6 (95% confidence interval [CI], 11.4–11.8) for both sexes, 14.9 (95% CI, 14.9–15.5) for males, and 8.3 (95% CI, 7.9–8.3) for females. The age-adjusted annual incidence rate was 10.7 (95% CI, 10.3–11.1) in 2005 and 12.3 (95% CI, 11.9–12.8) in 2010. The annual incidence rate increased with age, peaked in August, was the highest in southern Taiwan, and correlated with monthly temperature.

Conclusions The annual incidence rate of NF in Taiwan was highest between 2005 and 2009 and slightly lower in 2010 in this study. Although additional studies are needed to identify modifiable risk factors associated with NF, the aforementioned risk factors alert the first line doctors, such as plastic surgeons, to pay much more attention to this complicated disease entity and make an accurate critical decision making for the patients.

From the *Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, †Graduate Institute of Clinical Medicine, ‡NCKU Research Center for Health Data, §International Research Center for Wound Repair and Regeneration (iWRR), and ∥Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Received October 14, 2017, and accepted for publication, after revision October 22, 2017.

Conflicts of interest and sources of funding: none declared.

Reprints: Shyh-Jou Shieh, MD, PhD, Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, and International Research Center for Wound Repair and Regeneration (iWRR), College of Medicine, National Cheng Kung University, 138 Sheng-Li Rd, Tainan 70403, Taiwan. E-mail: sjshieh@mail.ncku.edu.tw; or Tsung-Hsueh Lu, MD, PhD, NCKU Research Center for Health Data and Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan. E-mail: robertlu@mail.ncku.edu.tw.

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