The frequency of chronic comorbidities PF-6463922 rose markedly during the same period and may have increased risk of development of OF. This explanation is supported by occurrence of OF at a rate nearly twice as high among women with chronic comorbidities as compared to those with no reported chronic illness. The association of OF with chronic illness was also noted in the general population with NF. Psoinos et al. [6] reported an increase in development of OF among patients with NF over the past decade that was matched by marked increase in the burden of chronic comorbidities in a study of a national data set. We found prolonged hospital length of stay among

PNAF hospitalization, far exceeding the average 2.6 days for all pregnancy-related hospitalizations in the state [40]. Hospital length of stay among patients with PANF, often prolonged, has

been inconsistently reported by other investigators [9–12]. The findings of this study are comparable to prior reports on NF in the general population in the US [6, 23]. The fiscal burden of PANF has not been previously reported. The average, inflation-adjusted (2010 dollars), total hospital charges per hospitalization in this cohort make PANF the second most expensive selleck chemicals llc condition in the state, topped only by respiratory failure ($103,112) [40] and were nearly fivefold check details higher than the average charge for pregnancy-related hospitalization ($21,896) [40]. The average hospital charges in this study population were also markedly higher than those reported in the general population with necrotizing soft tissue infections, even when adjusted for inflation [39], though the sources of higher charges among PANF hospitalization are uncertain. Although there was no statistically significant change in hospital charges over the past

decade, the trend of declining charges may have resulted from increasing care efficiencies, as reflected by simultaneous downward trend of hospital length of stay, with no rise in discharges to other facilities. The finding of hospital mortality of 2% is markedly lower than that reported in prior case series, ranging from 17% [12] to 22% [11]. Possible explanations for the difference may include improving care, as the cited reports described patients managed during 1987–1994 [11] and 1986–2000 [12]. In addition, the small number of patients described (6 [12] and selleckchem 9 [11]) limits the precision of case fatality estimates for the general population, with the 95% CI of case fatality in these studies overlapping those in the present cohort. Moreover, the pattern of difference in case fatality between the cohort in the present and prior reports of PNAF, is similar to that noted in the general population with NF, with large (population-level) studies describing markedly lower morality rates than single/few center reports [6]. Indeed, a recent national study of necrotizing soft tissue infections by Psoinos et al.