ArticleAnnals of intensive care2019
Impact of a multidisciplinary care bundle for necrotizing skin and soft tissue infections: a retrospective cohort study.
Article in Annals of intensive care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- [Necrotizing soft tissue infections].Die Anaesthesiologie · 2024Review
- Treating necrotizing skin and soft-tissue infections.Intensive care medicine · 2024Article
- Multiple Spinal Epidural Abscesses with Concomitant Multifocal Systemic Abscesses and Multi-joint Septic Arthritis:, A Case Report.Journal of orthopaedic case reports · 2024Article
- Necrotizing soft tissue infections in critically ill neutropenic patients: a French multicentre retrospective cohort study.Annals of intensive care · 2023Article
- Impact of prior antibiotic therapy on severe necrotizing soft-tissue infections in ICU patients: results from a French retrospective and observational study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2022Observational
- Antibiotics in Necrotizing Soft Tissue Infections.Antibiotics (Basel, Switzerland) · 2021Review
- Surviving Sepsis Campaign: Research Opportunities for Infection and Blood Purification Therapies.Critical care explorations · 2021Review
- Long-term quality of life in necrotizing soft-tissue infection survivors: a monocentric prospective cohort study.Annals of intensive care · 2021Article
- Should the Clinical Pharmacologist Play a Role in the Multidisciplinary Team Managing Severe Necrotizing Soft-Tissue Infections?Clinical pharmacokinetics · 2021Article
- Understanding necrotizing soft tissue infections in the intensive care unit.Intensive care medicine · 2020Article
- Determinants of Mortality in Necrotizing Soft Tissue Infections.Hellenike cheirourgike. Acta chirurgica Hellenica · 2020Article
- Early identification of patients at high risk of group A streptococcus-associated necrotizing skin and soft tissue infections: a retrospective cohort study.Critical care (London, England) · 2019Article
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11 authors.
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Abstract
backgroundNecrotizing skin and soft tissue infections (NSTIs) require both prompt medical and surgical treatment. The coordination of multiple urgent interventions by care bundles has improved outcome in other settings. This study aimed to assess the impact of a multidisciplinary care bundle on management and outcome of patients with NSTIs.
methodsPatients with NSTIs admitted between 2006 and 2017 were compared according to admission before or after bundle implementation (2012-2013). This bundle consisted mainly in (1) the creation of a multidisciplinary task force; (2) management guidelines on empirical antibiotics, intensive care unit admission criteria, a triage algorithm to accelerate operating room access; and (3) an active communication policy. Patient recruitment and management were compared between pre- and post-implementation periods. Main outcome was day 60-censored hospital survival.
resultsOverall, 224 patients were admitted: 60 before, 35 during, and 129 after bundle implementation. Admission after implementation was associated with increased yearly admissions (10 [8-13] vs 30 [24-43] patients/year, p = 0.014) and decreased mortality (30 vs 15%, HR = 0.49 [0.26-0.92]; p = 0.026) but was no longer a protective factor for mortality after adjustment on confounding factors (adjusted HR = 0.90 [0.43-1.88], p = 0.780). There was no significant difference regarding time to surgery (0 [0-1] vs 0 [0-1] days, p = 0.192) or rate of antibiotic treatment within 24 h (98% vs 99%, p > 0.99).
conclusionsImplementation of a multidisciplinary care bundle for NSTIs was feasible, but in a retrospective study from an already experienced center was not associated with significantly increased survival after adjustment.
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