ArticlePloS one2019
An elevated glycemic gap predicts adverse outcomes in diabetic patients with necrotizing fasciitis.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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.
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.
Who cites it
14 citing papers in PubMed, 23 citations in OpenAlex.
- 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 · 2026Article
- Diagnostic and prognostic utility of SIRI and CAR in necrotizing fasciitis: a retrospective cohort study on disease severity and clinical outcomes.European journal of medical research · 2026Article
- Stress hyperglycemia ratio predicts adverse outcomes in emergency department patients with upper gastrointestinal bleeding.PloS one · 2026Article
- Consensus on the Diagnosis and Treatment of Adult Necrotizing Fasciitis (2025 Edition).Burns & trauma · 2025Article
- Diagnostic Key Points and Surgical Management of Necrotizing Fasciitis: A Retrospective Study.The international journal of lower extremity wounds · 2024Article
- Observational
- Differences Between Patients With Diabetes Mellitus and Those Without in Cases of Necrotizing Fasciitis.Cureus · 2023Article
- Glucometabolic changes influence hospitalization and outcome in patients with COVID-19: An observational cohort study.Diabetes research and clinical practice · 2022Observational
- Glycemic Gap as a Useful Surrogate Marker for Glucose Variability and Progression of Diabetic Retinopathy.Journal of personalized medicine · 2021Article
- Stress Induced Hyperglycemia in the Context of Acute Coronary Syndrome: Definitions, Interventions, and Underlying Mechanisms.Frontiers in cardiovascular medicine · 2021Review
- Susceptibility for Some Infectious Diseases in Patients With Diabetes: The Key Role of Glycemia.Frontiers in public health · 2021Review
- Necrotizing Fasciitis: A Predictable Burden in Rural Kenya.World journal of surgery · 2020Article
- Augmented glycaemic gap is a marker for an increased risk of post-infarct left ventricular systolic dysfunction.Cardiovascular diabetology · 2020Article
- WHAT IS STRESS HYPERGLYCEMIA? A SUGGESTION FOR AN IMPROVEMENT OF ITS DEFINITION.Acta endocrinologica (Bucharest, Romania : 2005)Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiabetes is the most common comorbidity of necrotizing fasciitis (NF), but the effect of stress-induced hyperglycemia (SIH) on diabetic patients with NF has never been investigated. The aim of this study was to assess whether SIH, as determined by the glycemic gap between admission glucose levels and A1C-derived average glucose levels, predicts adverse outcomes in diabetic patients hospitalized with NF.
methodsWe retrospectively reviewed the glycemic gap and clinical outcomes in 252 diabetic patients hospitalized due to NF from 2011 to 2018 in a single medical center in Taiwan. A receiver operating characteristic (ROC) curve was used to analyze the optimal cutoff values for predicting adverse outcomes. Univariate and multivariate logistic regression analyses were employed to identify significant predictors of adverse outcomes.
resultsIn total, 194 diabetic NF patients were enrolled. Compared with patients without adverse outcomes, patients with adverse outcomes had significantly higher glycemic gaps, Acute Physiology and Chronic Health Evaluation (APACHE) II scores and C-reactive protein (CRP) levels; lower albumin and hemoglobin levels; greater incidence of limb loss; and longer hospital and intensive care unit stays. The glycemic gap positively correlates with the laboratory risk indicator for NF scores, APACHE II scores and CRP levels. A glycemic gap of 146 mg/dL was the optimal cutoff value for predicting adverse outcomes using the ROC curve. Compared with patients with glycemic gaps ≤146 mg/dL, those with glycemic gaps >146 mg/dL had higher APACHE II scores and incidence rates of adverse outcomes, especially bacteremia and acute kidney injury. Multivariate analysis revealed that a glycemic gap >146 mg/dL and APACHE II score >15 were independent predictors of adverse outcomes, while the presence of hyperglycemia at admission was not.
conclusionsAn elevated glycemic gap was significantly independently associated with adverse outcomes in diabetic NF patients. Further prospective studies are warranted to validate the role of the glycemic gap in NF patients with diabetes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.