Evidence map›Paper›PMID 34996417›Full record

ArticleBMC surgery2022

The impact of operative time on the outcomes of necrotizing soft tissue infections: a multicenter cohort study.

Femke Nawijn, Mark van Heijl, Jort Keizer, Paul J van Koperen, Falco Hietbrink

Open access · goldAbstract readMulticenter Study
In one paragraph

Article in BMC surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.0field-weighted citation impact, top 26% of its field
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

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 5 citations in OpenAlex.

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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

5 authors at 3 institutions in 1 country.

Femke NawijnDepartment of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. f.nawijn-3@umcutrecht.nl.ORCID http://orcid.org/0000-0001-8390-4483
Mark van HeijlDepartment of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Jort KeizerDepartment of Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
Paul J van KoperenDepartment of Surgery, Meander Medical Center, Hoogland, The Netherlands.
Falco HietbrinkDepartment of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
University Medical Center Utrecht · NLMeander Medisch Centrum · NLSt. Antonius Ziekenhuis · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe primary aim of this study was to identify if there is an association between the operative time of the initial debridement for necrotizing soft tissue infections (NSTIs) and the mortality corrected for disease severity.

methodsA retrospective multicenter study was conducted of all patients with NSTIs undergoing surgical debridement. The primary outcome was the 30-day mortality. The secondary outcomes were days until death, length of intensive care unit (ICU) stay, length of hospital stay, number of surgeries within first 30 days, amputations and days until definitive wound closure.

resultsA total of 160 patients underwent surgery for NSTIs and were eligible for inclusion. Twenty-two patients (14%) died within 30 days and 21 patients (13%) underwent an amputation. The median operative time of the initial debridement was 59 min (IQR 35-90). In a multivariable analyses, corrected for sepsis just prior to the initial surgery, estimated total body surface (TBSA) area affected and the American Society for Anesthesiologists (ASA) classification, a prolonged operative time (per 20 min) was associated with a prolonged ICU (β 1.43, 95% CI 0.46-2.40; p = 0.004) and hospital stay (β 3.25, 95% CI 0.23-6.27; p = 0.035), but not with 30-day mortality. Operative times were significantly prolonged in case of NSTIs of the trunk (p = 0.044), in case of greater estimated TBSA affected (p = 0.006) or if frozen sections and/or Gram stains were assessed intra-operatively (p < 0.001).

conclusionsProlonged initial surgery did not result in a higher mortality rate, possible because of a short duration of surgery in most studied patients. However, a prolonged operative time was associated with a prolonged ICU and hospital stay, regardless of the estimated TBSA affected, presence of sepsis prior to surgery and the ASA classification. As such, keeping operative times as limited as possible might be beneficial for NSTI patients.

Indexed as

Soft Tissue InfectionsAmputation, SurgicalDebridementHumansLength of StayOperative TimeRetrospective StudiesDamage controlMortalityNecrotizing fasciitisNecrotizing soft tissue infectionsOperative timeSevere necrotizing soft tissue infection

Identifiers

PMID34996417
PMCPMC8742342
OpenAlexW4206290752

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.