Evidence map›Paper›PMID 31185920›Full record

ArticleBMC infectious diseases2019

Risk factors of synchronous multifocal necrotizing fasciitis: a case control study in comparison with monofocal necrotizing fasciitis in Taiwan.

Ching-Yu Lee, Tsan-Wen Huang, Meng-Huang Wu, Tsung-Jen Huang, Yan-Rong Li, Evelyn Jou-Chen Huang, Yao-Hung Tsai

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
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

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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

5 citing papers in PubMed.

  1. Observational
  2. Multifocal necrotizing fasciitis: what makes it different? A German trauma center experience.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026
    Article
  3. Article
  4. Article
  5. Article
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

7 authors.

Ching-Yu LeeDepartment of Orthopedics, Taipei Medical University Hospital, No. 252, Wuxing St., Taipei, 11031, Taiwan.
Tsan-Wen HuangDepartment of Orthopedic Surgery, Chiayi Chang Gung Memorial Hospital, No. 6, West Sec., Jiapu Road, Puzi City, Chiayi, 613, Taiwan.
Meng-Huang WuDepartment of Orthopedics, Taipei Medical University Hospital, No. 252, Wuxing St., Taipei, 11031, Taiwan.
Tsung-Jen HuangDepartment of Orthopedics, Taipei Medical University Hospital, No. 252, Wuxing St., Taipei, 11031, Taiwan.
Yan-Rong LiDepartment of Internal Medicine, Division of Endocrinology and Metabolism, Chang Gung Memorial Hospital, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 33305, Taiwan.
Evelyn Jou-Chen HuangDepartment of Ophthalmology, Taipei Medical University Hospital, No. 252, Wuxing St., Taipei, 11031, Taiwan. roro691213@gmail.com.
Yao-Hung TsaiDepartment of Orthopedic Surgery, Chiayi Chang Gung Memorial Hospital, No. 6, West Sec., Jiapu Road, Puzi City, Chiayi, 613, Taiwan. orthoejaca22@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMonofocal necrotizing fasciitis (MONF) involves a single site in a rapidly progressing infection and necrosis of the fascia and surrounding soft tissue. Synchronous multifocal necrotizing fasciitis (SMNF), the simultaneous development of NF in multiple noncontiguous sites, is rarely reported. This study aimed to compare the clinical characteristics and outcomes between patients with SMNF and MONF, and to determine the risk factors of SMNF.

methodsOur retrospective case-control study compared the clinical characteristics and outcomes, between January 2006 and January 2013, of patients with SMNF and of patients with MONF of the extremities.

resultsWe enrolled 144 patients with NF of the extremities: 19 with SMNF and 125 with MONF. The duration of symptoms before admission was significantly shorter for the former than for the latter (1.7 days vs. 3.3 days, p = 0.001); the prevalence of shock at the initial visit significantly higher (73.7% vs. 36%, p = 0.002); and the total-case postoperative mortality rate significantly higher (68.4% vs. 14.4%, p <  0.001). In further analysis of the total-case mortality, 9 in 13 SMNF deaths (69.2%) within 7 days after fasciotomy were in the majority while 13 with 28-day mortality (72.2%) was the majority of MONF deaths (p <  0.001). SMNF was significantly more likely to involve bacteremia (89.5% vs. 36%, p <  0.001). Independent risk factors for SMNF were liver cirrhosis (LC) (odds ratio [OR] 6.0, p = 0.001) and end-stage renal disease (ESRD) (OR 7.1, p = 0.035). Gram-negative bacteria were most common in SMNF, and Gram-positive bacteria in MONF (83.3% vs. 53.3%, p = 0.005). Vibrio species were the most common single microbial cause (35.4%) of all NF patients and were the overwhelming cause (73.7%) of SMNF. Staphylococcus aureus and group A β-hemolytic streptococcus (45.6%) were the other predominant causes of MONF while both (10.5%) rarely caused multifocal NF.

conclusionsSMNF was more fulminant than was MONF. SMNF was attributable primarily to marine Gram-negative bacteria. Physicians should be aware of SMNF because of its extremely high mortality rate.

Indexed as

AgedCase-Control StudiesCoinfectionComorbidityFasciitis, NecrotizingFemaleHumansMaleMiddle AgedPrevalencePrognosisRetrospective StudiesRisk FactorsTaiwanSynchronous multifocal necrotizing fasciitis

Identifiers

PMID31185920
PMCPMC6558844

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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.