Time Is Fascia: Laboratory and Anamnestic Risk Indicators for Necrotizing Fasciitis

Breidung, David; Grieb, Gerrit; Malsagova, Asja T.; Barth, Andrè A.; Billner, Moritz; Hitzl, Wolfgang; Reichert, Bert; Megas, Ioannis-Fivos

doi:10.1089/sur.2022.222

Cited by 4 publications

(7 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The words “life-threatening” and “mortality” are a recurring theme in the existing literature on necrotizing fasciitis [ 1 , 5 , 7 ]. Many researchers have been engaged in developing or evaluating existing scoring systems to aid in the diagnosis of NF [ 4 , 7 , 8 , 9 , 11 , 12 , 13 , 14 , 19 ]. However, the existing literature regarding the factors that are prognostic for the mortality of proven NF remains sparse.…”

Section: Discussionmentioning

confidence: 99%

“…The statistically significant prognostic value of the LARINF score ( p = 0.02) also appears plausible, as it adds a number of clinical indicators (such as heart/liver/renal insufficiency/obesity and immunosuppression) to the laboratory indicators, which, when evaluated individually in other studies (>2 comorbidities), also yielded significant prognostic values [ 4 , 15 ]. This result is partially consistent with the results of van Stigt et al In their study, which involved 123 patients, they concluded that the LRINEC score should be used for all patients with suspected necrotizing fasciitis and that older patients with two or more comorbidities have a higher mortality rate [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Type 2 denotes monomicrobial infections caused by Gram-positive pathogens, whereas Type 3 involves Gram-negative pathogens, and Type 4 encompasses fungal infections [ 2 , 3 ]. Despite its rarity, necrotizing fasciitis should be considered as a possible diagnosis in various scenarios of soft tissue infections, as it progresses rapidly [ 4 , 5 ]. The importance of recognizing NF at an early stage is a well-known fact [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…The importance of recognizing NF at an early stage is a well-known fact [ 6 ]. Several scoring systems have been developed over the years to help with initial decision making [ 4 , 7 , 8 , 9 ]. These have already been examined with regard to their reliability for diagnosis and also for prognostic accuracy [ 9 , 10 , 11 , 12 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Prognostic Factors in Necrotizing Fasciitis: Insights from a Two-Decade, Two-Center Study Involving 209 Cases

Megas,

Delavari,

Marti Edo

et al. 2024

Infectious Disease Reports

Self Cite

View full text Add to dashboard Cite

Introduction: Necrotizing fasciitis (NF) is a critical disease with high morbidity and mortality rates that poses significant challenges in diagnosis and treatment. Prognostic factors for the clinical course of NF remain unclear and are currently under research. This study aims to identify such factors in a large cohort of patients which represents a major comprehensive investigation of prognostic factors for NF. Methods: Retrospective analysis was conducted on necrotizing fasciitis cases from 2003 to 2023 at two German hospitals. Data included demographics, comorbidities, laboratory findings, infection site, causative microorganisms and outcomes. Statistical analysis involved t-tests, chi-square tests, and ROC analysis. Results: A total of 209 patients were included, with a mortality rate of 18%. Patients were categorized into survivors (n = 171) and non-survivors (n = 38). Non-survivors were significantly older (68.9 ± 13.9 years vs. 55.9 ± 14.3 years; p < 0.01) and exhibited a higher prevalence of peripheral vascular diseases, cancer, and heart, liver, or renal insufficiency. Laboratory findings and scoring results also varied significantly between the two groups. The ROC curve analysis identified age as a predictor of mortality, with an optimal cut-off value of 68.5 years (sensitivity: 60.5%, specificity: 81.9%). Higher age was associated with increased mortality risk. Conclusions: The patient’s age stands out as the primary predictive element for mortality in necrotizing fasciitis. Additionally, we advocate for employing the Laboratory and Anamnestic Risk Indicator for Necrotizing Fasciitis (LARINF—score), which holds substantial prognostic significance and is straightforward to calculate. Considering our findings, crafting a clinical algorithm or scoring mechanism to forecast mortality in NF would be a promising target for future research.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prognostic Factors in Necrotizing Fasciitis: Insights from a Two-Decade, Two-Center Study Involving 209 Cases

Megas,

Delavari,

Marti Edo

et al. 2024

Infectious Disease Reports

Self Cite

View full text Add to dashboard Cite

show abstract

“… 3 An adjunct to decision-making presented by our clinic is the Laboratory and Anamnestic Risk Indicator for Necrotizing Fasciitis score, which includes three laboratory parameters as well as three comorbidities. 4 In this case report, we present a compelling and instructive instance of a patient who developed NF after a body contouring surgery.…”

mentioning

confidence: 99%

Necrotizing Fasciitis after Panniculectomy Caused by Finegoldia magna

Breidung,

Delavari,

Megas

et al. 2024

Plastic and Reconstructive Surgery - Global Open

Self Cite

View full text Add to dashboard Cite

Summary: Necrotizing fasciitis is a rare yet severe complication after body contouring surgery. We present a case of a 54-year-old woman with a complex medical history who developed necrotizing fasciitis 9 days after panniculectomy and epigastric hernia repair. Microbiological examination revealed Finegoldia magna as the causative agent, a rare pathogen in necrotizing fasciitis. Patients undergoing body contouring may be at increased risk of developing necrotizing fasciitis; therefore, increased attention should be paid to this differential diagnosis in case of postoperative signs of infection. This case report highlights the pivotal importance of early recognition, prompt surgical intervention, and comprehensive medical treatment to improve patient outcomes in necrotizing fasciitis.

show abstract

Increase in Streptococcal Necrotizing Fasciitis During and After the Coronavirus Disease 2019 Pandemic

Breidung,

Billner,

Megas

et al. 2024

Surgical Infections

View full text Add to dashboard Cite

Time Is Fascia: Laboratory and Anamnestic Risk Indicators for Necrotizing Fasciitis

Cited by 4 publications

References 26 publications

Prognostic Factors in Necrotizing Fasciitis: Insights from a Two-Decade, Two-Center Study Involving 209 Cases

Prognostic Factors in Necrotizing Fasciitis: Insights from a Two-Decade, Two-Center Study Involving 209 Cases

Necrotizing Fasciitis after Panniculectomy Caused by Finegoldia magna

Increase in Streptococcal Necrotizing Fasciitis During and After the Coronavirus Disease 2019 Pandemic

Contact Info

Product

Resources

About