ArticleJournal of orthopaedic surgery and research2019
Lactate on emergency department arrival as a predictor of in-hospital mortality in necrotizing fasciitis: a retrospective study.
Article in Journal of orthopaedic surgery and research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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15 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Necrotising Fasciitis in Patients With Diabetes: A Systematic Review of Mortality-Associated Clinical Factors.International wound journal · 2026Pooled it
- Host-response trajectories in necrotizing fasciitis: host-pathogen interactions, immune evasion, and immunoparalysis.Frontiers in cellular and infection microbiology · 2026Review
- A universal oxygen scavenger for oxidase-based biosensors.Science advances · 2025Article
- Epidemiology and prognostic factors of necrotizing fasciitis in resource-limited regions based on 119 cases.Scientific reports · 2025Article
- Machine Learning Approach to ClassifyInfection and drug resistance · 2024Article
- Initial skin necrosis presentation at emergency room was associated with fulminant clinical course and mortality in patients with Vibrio necrotizing fasciitis.Scientific reports · 2023Article
- Article
- In-hospital mortality associated with necrotizing soft tissue infection due to Vibrio vulnificus: a matched-pair cohort study.World journal of emergency surgery : WJES · 2022Article
- Necrotizing Soft Tissue Infections in Intensive Care.Journal of intensive care medicine · 2022Observational
- Differentiating Upper Extremity Necrotizing Soft Tissue Infection From Serious Cellulitis and Abscess.Cureus · 2021Article
- Utility of modified Laboratory Risk Indicator for Necrotizing Fasciitis (MLRINEC) score in distinguishing necrotizing from non-necrotizing soft tissue infections.World journal of emergency surgery : WJES · 2021Article
- Utility of the Lactate/Albumin Ratio as a Predictor for Mortality in Necrotizing Fasciitis Patients.Emergency medicine international · 2021Article
- Differentiating Lower Extremity Necrotizing Soft Tissue Infection from Severe Cellulitis by Laboratory Parameters and Relevant History Points.Infection and drug resistance · 2021Article
- Predictors for gram-negative monomicrobial necrotizing fasciitis in southern Taiwan.BMC infectious diseases · 2020Article
- The association of ESBLDrug target insightsArticle
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHyperlactatemia is known to be associated with adverse outcome in critical illness. In this study, we attempted to identify if hyperlactatemia on emergency department (ED) arrival is a reliable predictor for in-hospital mortality in necrotizing fasciitis (NF) patients.
methodA prospective cohort study of hospitalized patients with NF was conducted in two tertiary teaching hospitals in Taiwan between March 2010 and March 2018. Blood samples were collected in the ED upon arrival, and the lactate levels were determined. Sequential organ failure assessment (SOFA) scores were calculated during the first 24 h after admission. All collected data were statistically analyzed.
resultOf the 707 NF patients, 40 (5.66%) died in the hospital. The median (interquartile range) blood lactate level in all NF patients was 3.6 mmol/l (2.2-4.8). The blood lactate level upon ED arrival was significantly associated with mortality (odds ratio [OR] = 1.35; 95% confidence interval [CI], 1.30-1.46; P < 0.001), even after adjustment for age and SOFA score (OR = 1.27; P < 0.001). Multivariate regression analysis showed that a high blood lactate level (OR = 1.17; 95% CI, 1.07-1.29; P = 0.001) and a high SOFA score (OR = 1.15; 95% CI, 1.11-1.20; P < 0.001) were independent risk factors for in-hospital mortality in NF. Blood lactate achieved an area under-the-receiver-operating-characteristic curve (AUC) of 0.79 (P < 0.001) for predicting mortality that was similar to that of SOFA score (AUC = 0.82; P < 0.001). Blood lactate displayed a sensitivity of 62% and a specificity of 86% in predicting mortality at the optimal cutoff value of 5.80 mmol/l.
conclusionIn necrotizing fasciitis patients, hyperlactatemia on ED arrival is independently associated with in-hospital mortality. NF patients with hyperlactatemia on ED arrival should be closely monitored for signs of deterioration and consider early and aggressive intervention to prevent mortality.
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