Invasive group A streptococcal disease and intensive care unit admissions

Objective: To determine the clinical epidemiology of invasive group A streptococcal disease (IGASD) and identify predictors of admissions, into an intensive care unit (ICU). Design: A cross-sectional study. Setting: Retrospective review of data. Patients: A total of 204 patients hospitalized throughout the state of Florida, United States, between August 1996 and August 2000 for IGASD. Intervention: None. Measurements and results: Prevalence odds ratios for ICU admissions were calculated for several demographic and clinical variables. The prevalence of ICU admissions was lower among patients 69 years of age or older compared to younger patients (odds ratio=0.43, 90% confidence interval: 0.23-0.83). The odds ratio associated with the presence of necrotizing fasciitis was 6.98 (90% confidence interval: 3.13-15.58). Conclusion: In this analysis of patients hospitalized for IGASD, the presence of necrotizing fasciitis was the strongest factor associated with admissions into an ICU.