Evidence map›Paper›PMID 37166568›Full record

Observational studyLangenbeck's archives of surgery2023

Factors associated with mortality in patients with extremity necrotizing soft-tissue infections: a single academic center experience.

Keita Nagira, Tomofumi Ogoshi, Keiichi Akahori, Shinpei Enokida, Makoto Enokida, Takahiro Ueda, Masato Homma, Hideki Nagashima

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Langenbeck's archives of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.3field-weighted citation impact, top 41% 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

3 citing papers in PubMed, 1 citations in OpenAlex.

  1. Article
  2. Factors associated with in-hospital mortality in necrotising soft tissue infections. a multicentre retrospective cohort study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026
    Article
  3. Review
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

8 authors at 1 institution in 1 country.

Keita NagiraDepartment of Orthopedic Surgery, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, Tottori, 683-8504, Japan. nagira@tottori-u.ac.jp.ORCID http://orcid.org/0000-0003-0973-6295
Tomofumi OgoshiDepartment of Emergency and Disaster Medicine, Tottori University, Tottori, Japan.ORCID http://orcid.org/0000-0001-8943-3037
Keiichi AkahoriDepartment of Orthopedic Surgery, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, Tottori, 683-8504, Japan.
Shinpei EnokidaDepartment of Orthopedic Surgery, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, Tottori, 683-8504, Japan.ORCID http://orcid.org/0000-0003-4450-115X
Makoto EnokidaDepartment of Orthopedic Surgery, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, Tottori, 683-8504, Japan.ORCID http://orcid.org/0000-0001-7908-4638
Takahiro UedaDepartment of Emergency and Disaster Medicine, Tottori University, Tottori, Japan.ORCID http://orcid.org/0000-0002-4214-1325
Masato HommaDepartment of Emergency and Disaster Medicine, Tottori University, Tottori, Japan.
Hideki NagashimaDepartment of Orthopedic Surgery, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, Tottori, 683-8504, Japan.ORCID http://orcid.org/0000-0002-2896-8406
Tottori University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeNecrotizing soft-tissue infection (NSTI) is a surgical emergency associated with high mortality. This study primarily aimed to identify the factors associated with in-hospital mortality due to NSTI in the extremities at a single institution. Secondarily, we aimed to clarify the effectiveness of the optimal combination of hyperbaric oxygen therapy (HBOT) and surgery for NSTI treatment. STUDY

designRetrospective observational study.

methodsThis study included all patients newly diagnosed with NSTI in the extremity from 2003 to 2021 in our hospital. Factors associated with mortality, including patient's characteristics, duration from onset to hospitalization, NSTI type, and clinical data at the initial visit; acute disseminated intravascular coagulation (DIC), laboratory risk indicator for necrotizing fasciitis score, and sequential organ failure assessment score; treatment, initial surgery, surgery times, amputation, HBOT, combined surgery with HBOT, and clinical outcomes; amputation rate, mortality rate, and hospitalization duration were examined.

resultsA total of 37 cases were treated for NSTIs. The median age was 64 years (range: 22-86). Five cases (13.5%) died during hospitalization. Ten patients were diagnosed with DIC at the initial visit, of whom four died. HBOT combined with surgery was performed in 23 cases, and 16 cases underwent multiple surgeries. Factors associated with mortality included DIC (p = 0.015, 95% confidence interval [CI]: 0.015-0.633) and multiple surgeries combined with HBOT (p = 0.028, 95% CI: 1.302-95.418).

conclusionThis study demonstrates that DIC at the initial visit is associated with mortality in extremity NSTI. Additionally, HBOT might improve prognosis when combined with multiple surgeries.

Indexed as

Fasciitis, NecrotizingSoft Tissue InfectionsExtremitiesHospitalizationHumansMiddle AgedPrognosisRetrospective StudiesRisk FactorsDisseminated intravascular coagulationHyperbaric oxygen therapyMortalityNecrotizing soft-tissue infectionsSurgery

Identifiers

PMID37166568
OpenAlexW4376133059

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.