Evidence map›Paper›PMID 28863028›Full record

Observational studyShock (Augusta, Ga.)2018

Associations of Plasma Nitrite, L-Arginine and Asymmetric Dimethylarginine With Morbidity and Mortality in Patients With Necrotizing Soft Tissue Infections.

Marco B Hansen, Lars S Rasmussen, Peter Garred, Katrine Pilely, Anna M Wahl, Anders Perner, Martin B Madsen, Elise R Hedegaard, Ulf Simonsen, Ole Hyldegaard

Open access · hybridAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Shock (Augusta, Ga.), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.7field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 11 citations in OpenAlex.

  1. Trial
  2. Review
  3. Review
  4. Review
  5. Article
  6. Hyperbaric oxygen treatment impacts oxidative stress markers in patients with necrotizing soft-tissue infection.Journal of investigative medicine : the official publication of the American Federation for Clinical Research · 2021
    Observational
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Marco B HansenDepartment of Anesthesia, Center of Head and Orthopedics, Rigshospitalet, University of Copenhagen, Denmark.
Lars S RasmussenDepartment of Anesthesia, Center of Head and Orthopedics, Rigshospitalet, University of Copenhagen, Denmark.
Peter GarredLaboratory of Molecular Medicine, Department of Clinical Immunology, Rigshospitalet, University of Copenhagen, Denmark.
Katrine PilelyLaboratory of Molecular Medicine, Department of Clinical Immunology, Rigshospitalet, University of Copenhagen, Denmark.
Anna M WahlDepartment of Anesthesia, Center of Head and Orthopedics, Rigshospitalet, University of Copenhagen, Denmark.
Anders PernerDepartment of Intensive Care, Rigshospitalet, University of Copenhagen, Denmark.
Martin B MadsenDepartment of Intensive Care, Rigshospitalet, University of Copenhagen, Denmark.
Elise R HedegaardDepartment of Biomedicine, Pulmonary and Cardiovascular Pharmacology, University of Aarhus, Denmark.
Ulf SimonsenDepartment of Biomedicine, Pulmonary and Cardiovascular Pharmacology, University of Aarhus, Denmark.
Ole HyldegaardDepartment of Anesthesia, Center of Head and Orthopedics, Rigshospitalet, University of Copenhagen, Denmark.
University of Copenhagen · DKRigshospitalet · DKAarhus University · DK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe nitric oxide system could play an important role in the pathophysiology related to necrotizing soft tissue infection (NSTI). Accordingly, we investigated the association between plasma nitrite level at admission and the presence of septic shock in patients with NSTI. We also evaluated the association between nitrite, asymmetric dimethylarginine (ADMA), L-arginine, L-arginine/ADMA ratio, and outcome.

methodsWe analyzed plasma from 141 NSTI patients taken upon hospital admission. The severity of NSTI was assessed by the presence of septic shock, Simplified Acute Physiology Score (SAPS) II, Sepsis-Related Organ Failure Assessment (SOFA) score, use of renal replacement therapy (RRT), amputation, and 28-day mortality.

resultsNo difference in nitrite levels was found between patients with and without septic shock (median 0.82 μmol/L [interquartile range (IQR) 0.41-1.21] vs. 0.87 μmol/L (0.62-1.24), P = 0.25). ADMA level was higher in patients in need of RRT (0.64 μmol/L (IQR 0.47-0.90) vs. (0.52 μmol/L (0.34-0.70), P = 0.028), and ADMA levels correlated positively with SAPS II (rho = 0.32, P = 0.0002) and SOFA scores (rho = 0.22, P = 0.01). In a logistic regression analysis, an L-arginine/ADMA ratio below 101.59 was independently associated with 28-day mortality, odds ratio 6.03 (95% confidence interval, 1.41-25.84), P = 0.016. None of the other analyses indicated differences in the NO system based on differences in disease severity.

conclusionsIn patients with NSTI, we found no difference in baseline nitrite levels according to septic shock. High baseline ADMA level was associated with the use of RRT and patients with a low baseline L-arginine/ADMA ratio were at higher risk of dying within 28 days after hospital admission.

Indexed as

Hospital MortalityAdultAgedArginineBiomarkersDisease-Free SurvivalFemaleHumansMaleMiddle AgedNitritesProspective StudiesSeverity of Illness IndexShock, SepticSoft Tissue InfectionsSurvival RateArginineBiomarkersNitritesN,N-dimethylarginine

Identifiers

PMID28863028
PMCPMC5929495
OpenAlexW2753709976

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.