{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T16:53:09Z","timestamp":1793638389202,"version":"4.5.1"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2021,5,27]],"date-time":"2021-05-27T00:00:00Z","timestamp":1622073600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,5,27]],"date-time":"2021-05-27T00:00:00Z","timestamp":1622073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Trauma Emerg Surg"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Necrotizing fasciitis (NF) is a severe soft tissue infection with a high morbidity and mortality. With early diagnosis and treatment this could be reduced. Unfortunately, the diagnosis of necrotizing fasciitis can be very difficult. In recent years many risk factors have been identified. In 2004, the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score was developed. A tool that could help diagnosing NF. In this study, we search for prognostic factors for mortality in necrotizing fasciitis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>All adult patients with histopathological or surgical confirmed NF needed to be admitted to the intensive care unit for at least 24\u00a0h between January 2003 and December 2017 in five hospitals from the Nijmegen teaching region were included. We excluded patients with other forms of soft tissue infections or patients with an intensive care unit (ICU) stay of\u2009&lt;\u200924\u00a0h because we exclusively wanted to include patients with a fulminant course of necrotizing fasciitis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We have included 123 cases. The overall mortality was 31.7% (<jats:italic>N<\/jats:italic>\u2009=\u200939). The overall mean LRINEC score was 7.4\u2009\u00b1\u20092.7. Patients who died as the result of NF had a significantly higher median LRINEC score (8 vs. 7, <jats:italic>p<\/jats:italic>\u2009=\u20090.034). Other parameters found to be associated with mortality are age\u2009\u2265\u200960\u00a0years, cardiovascular disease in the medical history,\u2009\u2265\u20092 comorbidities, and lactate level greater than 1.7\u00a0mmol\/L.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>LRINEC score should be calculated in all patients presenting with NF to provide an additional source for clinical outcome. A high LRINEC score could implicate a higher risk of mortality. Especially in elderly patients, with a cardiac history, more than two comorbidities or a lactate level greater than 1.7\u00a0mmol\/L.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00068-021-01706-z","type":"journal-article","created":{"date-parts":[[2021,5,27]],"date-time":"2021-05-27T19:02:51Z","timestamp":1622142171000},"page":"1189-1195","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Prognostic factors for mortality in 123 severe cases of necrotizing fasciitis in 5 hospitals in the Netherlands between 2003 and 2017"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1428-1248","authenticated-orcid":false,"given":"Sander","family":"van Stigt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merel","family":"Knubben","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Schrooten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,5,27]]},"reference":[{"key":"1706_CR1","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1186\/s13017-016-0080-7","volume":"11","author":"SF van Stigt","year":"2016","unstructured":"van Stigt SF, de Vries J, Bijker JB, Mollen RM, Hekma EJ, Lemson SM, et al. 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All local feasibility committees of each of the hospitals assessed and gave approval for expansion of the existing database.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}}]}}