Observational studyIntensive care medicine2018
Clinical spectrum and short-term outcome of adult patients with purpura fulminans: a French multicenter retrospective cohort study.
Observational study in Intensive care medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03216577 (Short and Long-term Outcomes of Purpura Fulminans in Adults), which is not on this map. Cited by 31 papers.
What it found
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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.
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.
Short and Long-term Outcomes of Purpura Fulminans in Adults
Who cites it
31 citing papers in PubMed, 56 citations in OpenAlex.
- Purpura fulminans following a dog bite.Intensive care medicine · 2026Article
- Article
- Article
- Invasive Meningococcal Disease-Changes in Epidemiologic Trends and Outcome over 24 Years in a Tertiary Care Hospital from Romania.Pathogens (Basel, Switzerland) · 2025Article
- Hemodynamic and neurological presentations of invasive meningococcal disease in adults: a nationwide study across 100+ French ICUs : The RETRO-MENINGO study.Intensive care medicine · 2025Article
- Characteristics and outcomes of ICU patients with sepsis transmitted by cats and dogs: the PETSEPSIS multicentre retrospective observational cohort study.Critical care (London, England) · 2025Observational
- Beyond the Rash: The Devastating Course of Meningococcal Purpura Fulminans in an Unvaccinated Young Adult.Cureus · 2025Article
- Acute infectious purpura fulminant due to Enterococcus faecium infection: a case report.Journal of medical case reports · 2025Article
- Protein C in adult patients with sepsis: from pathophysiology to monitoring and supplementation.Journal of anesthesia, analgesia and critical care · 2025Review
- Prosthetic Rehabilitation for a Patient With Purpura Fulminans Undergoing Quadruple Amputation: A Case Report.Cureus · 2024Article
- Acute Infectious Purpura Fulminans Complicated by Bacterial Translocation after Rectal Cancer Surgery: A Case Report.Medicina (Kaunas, Lithuania) · 2024Article
- Complete genome sequences of 11Microbiology resource announcements · 2024Article
- Critical bloodstream infection caused byFrontiers in medicine · 2024Article
- Purpura fulminans in a hyposplenic patient arising from pneumococcal sinusitis.BMJ case reports · 2023Article
- Purpura fulminans complicating scrub typhus and acute hepatitis E coinfection.BMJ case reports · 2023Article
- Skin biopsy in adult patients with meningococcal purpura fulminans: a multicenter retrospective cohort study.Critical care (London, England) · 2023Article
- Epidemiology and Clinical Burden of Meningococcal Disease in France: Scoping Review.Journal of clinical medicine · 2023Article
- Prevalence and clinical features of secondary skin lesions in septic patients with bloodstream infections.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2022Article
- Understanding purpura fulminans in adult patients.Intensive care medicine · 2022Article
- Purpura fulminans due toIDCases · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
27 authors at 17 institutions in 1 country.
Funding
Abstract
purposeData on purpura fulminans (PF) in adult patients are scarce and mainly limited to meningococcal infections. Our aim has been to report the clinical features and outcomes of adult patients admitted in the intensive care unit (ICU) for an infectious PF, as well as the predictive factors for limb amputation and mortality.
methodsA 17-year national multicenter retrospective cohort study in 55 ICUs in France from 2000 to 2016, including adult patients admitted for an infectious PF defined by a sudden and extensive purpura, together with the need for vasopressor support. Primary outcome variables included hospital mortality and amputation during the follow-up period (time between ICU admission and amputation, death or end of follow-up).
resultsAmong the 306 included patients, 126 (41.2%; 95% CI 35.6-46.9) died and 180 (58.8%; 95% CI 53.3-64.3) survived during the follow-up period [13 (3-24) days], including 51/180 patients (28.3%, 95% CI 21.9-35.5) who eventually required limb amputations, with a median number of 3 (1-4) limbs amputated. The two predominantly identified microorganisms were Neisseria meningitidis (63.7%) and Streptococcus pneumoniae (21.9%). By multivariable Cox model, SAPS II [hazard-ratio (HR) = 1.03 (1.02-1.04); p < 0.001], lower leucocytes [HR 0.83 (0.69-0.99); p = 0.034] and platelet counts [HR 0.77 (0.60-0.91); p = 0.007], and arterial blood lactate levels [HR 2.71 (1.68-4.38); p < 0.001] were independently associated with hospital death, while a neck stiffness [HR 0.51 (0.28-0.92); p = 0.026] was a protective factor. Infection with Streptococcus pneumoniae [sub-hazard ratio 1.89 (1.06-3.38); p = 0.032], together with arterial lactate levels and ICU admission temperature, was independently associated with amputation by a competing risks analysis.
conclusionPurpura fulminans carries a high mortality and morbidity. Pneumococcal PF leads to a higher risk of amputation. TRIALS REGISTRATION: NCT03216577.
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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.