{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:05:46Z","timestamp":1789085146498,"version":"build-2803163510"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100013003","name":"Universit\u00e0 degli Studi di Cagliari","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100013003","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Trauma Emerg Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Necrotising soft tissue infections (NSTIs) are rare but life-threatening conditions associated with high mortality rates. This multicentre study aimed to identify admission variables associated with in-hospital mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included adult patients with surgically confirmed NSTIs treated at four high-volume academic referral centres in Italy between 2010 and 2024. Demographic, clinical, physiological, and laboratory variables available at hospital admission were analysed. Categorical variables were compared between survivors and non-survivors using the chi-square test or Fisher\u2019s exact test, while quantitative variables were compared using the Student\u2019s t test or Mann\u2013Whitney U test. Multivariable logistic regression analyses were performed to identify independent predictors of in-hospital mortality. Results were reported as ORs with 95%CI. A prognostic nomogram was developed from the final multivariable model, including variables independently associated with mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 379 patients were included. In-hospital mortality was 16.7%. In subgroup comparisons, mortality was 17.0% in necrotising fasciitis and 22.4% in Fournier\u2019s gangrene (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.275). In the overall NSTI population, age (aOR 1.061, 95%CI 1.037\u20131.087) and serum creatinine at admission (aOR 1.301, 95%CI 1.040\u20131.629) were independently associated with mortality. In subgroup analyses, age (aOR 1.079, 95%CI 1.051\u20131.114) and chronic kidney disease (aOR 2.885, 95%CI 1.141\u20137.283) remained associated with mortality in limb necrotizing fasciitis, while only age (aOR 1.074, 95%CI 1.030\u20131.124) remained independently associated with mortality in Fournier\u2019s gangrene. However, subgroup analyses in necrotising fasciitis of the limbs and Fournier\u2019s gangrene were limited by low event rates and should be considered exploratory. The nomogram based on age and serum creatinine predicted in-hospital mortality (AUC 0.775, 95% CI 0.711\u20130.831), with good agreement between predicted and observed outcomes across risk levels.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Media summary<\/jats:title>\n                    <jats:p>The FATAL-NSTI study identified age and serum creatinine at admission as key predictors of in-hospital mortality in necrotising soft tissue infections. A nomogram based on age and serum creatinine may support early risk stratification. #NecrotisingSoftTissuesInfections; #FournierGangrene; #NecrotisingFasciitis<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>NSTIs remain associated with substantial mortality. Age was the most consistent predictor of in-hospital mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00068-026-03242-0","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T06:19:08Z","timestamp":1781245148000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Factors associated with in-hospital mortality in necrotising soft tissue infections. a multicentre retrospective cohort study"],"prefix":"10.1007","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9941-0883","authenticated-orcid":false,"given":"Mauro","family":"Podda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Ceresoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Virdis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fausto","family":"Rosa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziana","family":"Pilia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Murzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Dess\u00ec","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Tedesco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Cina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Chiacchio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Vitiello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio Paolo","family":"Emma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano Piero Bernardo","family":"Cioffi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Altomare","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Cimbanassi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adolfo","family":"Pisanu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,12]]},"reference":[{"key":"3242_CR1","doi-asserted-by":"publisher","first-page":"e81","DOI":"10.1016\/S1473-3099(22)00583-7","volume":"23","author":"C Hua","year":"2023","unstructured":"Hua C, Urbina T, Bosc R, Parks T, Sriskandan S, de Prost N, Chosidow O. Necrotising soft-tissue infections. Lancet Infect Dis. 2023;23:e81\u201394.","journal-title":"Lancet Infect Dis"},{"key":"3242_CR2","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1097\/SLA.0000000000002774","volume":"269","author":"SM Fernando","year":"2019","unstructured":"Fernando SM, Tran A, Cheng W, Rochwerg B, Kyeremanteng K, Seely AJE, Inaba K, Perry JJ. Necrotizing Soft Tissue Infection: Diagnostic Accuracy of Physical Examination, Imaging, and LRINEC Score: A Systematic Review and Meta-Analysis. Ann Surg. 2019;269:58\u201365.","journal-title":"Ann Surg"},{"key":"3242_CR3","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1089\/sur.2020.099","volume":"22","author":"AK May","year":"2021","unstructured":"May AK, Talisa VB, Wilfret DA, Bulger E, Dankner W, Bernard A, Yende S. Estimating the Impact of Necrotizing Soft Tissue Infections in the United States: Incidence and Re-Admissions. Surg Infect (Larchmt). 2021;22:509\u201315.","journal-title":"Surg Infect (Larchmt)"},{"key":"3242_CR4","doi-asserted-by":"publisher","first-page":"1308","DOI":"10.1001\/jamasurg.2024.3365","volume":"159","author":"J McDermott","year":"2024","unstructured":"McDermott J, Kao LS, Keeley JA, Grigorian A, Neville A, de Virgilio C. Necrotizing Soft Tissue Infections: A Review. JAMA Surg. 2024;159:1308\u201315.","journal-title":"JAMA Surg"},{"key":"3242_CR5","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1046\/j.1365-2168.2000.01497.x","volume":"87","author":"N Eke","year":"2000","unstructured":"Eke N. Fournier\u2019s gangrene: a review of 1726 cases. Br J Surg. 2000;87:718\u201328.","journal-title":"Br J Surg"},{"key":"3242_CR6","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1016\/j.ijid.2019.12.030","volume":"92","author":"AE El-Qushayri","year":"2020","unstructured":"El-Qushayri AE, Khalaf KM, Dahy A, Mahmoud AR, Benmelouka AY, Ghozy S, Mahmoud MU, Bin-Jumah M, Alkahtani S, Abdel-Daim MM. Fournier\u2019s gangrene mortality: A 17-year systematic review and meta-analysis. Int J Infect Dis. 2020;92:218\u201325.","journal-title":"Int J Infect Dis"},{"key":"3242_CR7","doi-asserted-by":"publisher","first-page":"1718","DOI":"10.1016\/j.surg.2021.06.036","volume":"170","author":"CS Dhanasekara","year":"2021","unstructured":"Dhanasekara CS, Marschke B, Morris E, Kahathuduwa CN, Dissanaike S. Global patterns of necrotizing soft tissue infections: A systematic review and meta-analysis. Surgery. 2021;170:1718\u201326.","journal-title":"Surgery"},{"key":"3242_CR8","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1136\/bmj.330.7495.830","volume":"330","author":"S Hasham","year":"2005","unstructured":"Hasham S, Matteucci P, Stanley PR, Hart NB. Necrotising fasciitis. BMJ. 2005;330:830\u20133.","journal-title":"BMJ"},{"key":"3242_CR9","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1007\/s00068-025-03000-8","volume":"51","author":"J de Haan","year":"2025","unstructured":"de Haan J, Neeter LMFH, Suijker J, van Zuijlen PPM, Pijpe A, Meij-de Vries A, NSTI Knowledge Collaborative Group. Characteristics, treatments, and outcomes of patients with necrotizing soft tissue infections: a Dutch multicenter cohort study. Eur J Trauma Emerg Surg. 2025;51:321. https:\/\/doi.org\/10.1007\/s00068-025-03000-8.","journal-title":"Eur J Trauma Emerg Surg"},{"key":"3242_CR10","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1016\/j.jamcollsurg.2008.10.032","volume":"208","author":"B Sarani","year":"2009","unstructured":"Sarani B, Strong M, Pascual J, Schwab CW. Necrotizing fasciitis: current concepts and review of the literature. J Am Coll Surg. 2009;208:279\u201388.","journal-title":"J Am Coll Surg"},{"key":"3242_CR11","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1097\/TA.0000000000001857","volume":"85","author":"RB Gelbard","year":"2018","unstructured":"Gelbard RB, Ferrada P, Yeh DD, Williams BH, Loor M, Yon J, Mentzer C, Khwaja K, Khan MA, Kohli A, Bulger EM, Robinson BRH. Optimal timing of initial debridement for necrotizing soft tissue infection: A Practice Management Guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2018;85:208\u201314.","journal-title":"J Trauma Acute Care Surg"},{"key":"3242_CR12","doi-asserted-by":"publisher","first-page":"2253","DOI":"10.1056\/NEJMra1600673","volume":"377","author":"DL Stevens","year":"2017","unstructured":"Stevens DL, Bryant AE. Necrotizing Soft-Tissue Infections. N Engl J Med. 2017;377:2253\u201365.","journal-title":"N Engl J Med"},{"key":"3242_CR13","doi-asserted-by":"publisher","first-page":"678","DOI":"10.1097\/TA.0000000000004351","volume":"97","author":"EK Bisgaard","year":"2024","unstructured":"Bisgaard EK, Bulger EM. Current diagnosis and management of necrotizing soft tissue infections: What you need to know. J Trauma Acute Care Surg. 2024;97:678\u201386.","journal-title":"J Trauma Acute Care Surg"},{"key":"3242_CR14","doi-asserted-by":"publisher","first-page":"zrae022","DOI":"10.1093\/bjsopen\/zrae022","volume":"8","author":"MKR Vanguardia","year":"2024","unstructured":"Vanguardia MKR, Lew C, Prabhakaran S, Kong JCH. Fournier\u2019s gangrene: 15-year retrospective study at a tertiary hospital. BJS Open. 2024;8:zrae022. https:\/\/doi.org\/10.1093\/bjsopen\/zrae022.","journal-title":"BJS Open"},{"key":"3242_CR15","doi-asserted-by":"publisher","first-page":"e041302","DOI":"10.1136\/bmjopen-2020-041302","volume":"10","author":"M Hedetoft","year":"2020","unstructured":"Hedetoft M, Madsen MB, Madsen LB, Hyldegaard O. Incidence, comorbidity and mortality in patients with necrotising soft-tissue infections, 2005\u20132018: a Danish nationwide register-based cohort study. BMJ Open. 2020;10:e041302. https:\/\/doi.org\/10.1136\/bmjopen-2020-041302.","journal-title":"BMJ Open"},{"key":"3242_CR16","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1186\/1471-2334-11-5","volume":"11","author":"CY Lee","year":"2011","unstructured":"Lee CY, Kuo LT, Peng KT, Hsu WH, Huang TW, Chou YC. Prognostic factors and monomicrobial necrotizing fasciitis: gram-positive versus gram-negative pathogens. BMC Infect Dis. 2011;11:5. https:\/\/doi.org\/10.1186\/1471-2334-11-5.","journal-title":"BMC Infect Dis"},{"key":"3242_CR17","doi-asserted-by":"publisher","first-page":"2734","DOI":"10.1007\/s00268-019-05087-8","volume":"43","author":"E Eguia","year":"2019","unstructured":"Eguia E, Vivirito V, Cobb AN, Janjua H, Cheung M, Kuo PC. Predictors of Death in Necrotizing Skin and Soft Tissue Infection. World J Surg. 2019;43:2734\u20139.","journal-title":"World J Surg"},{"key":"3242_CR18","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1093\/cid\/ciaa027","volume":"72","author":"T Bruun","year":"2021","unstructured":"Bruun T, Rath E, Madsen MB, Oppegaard O, Nekludov M, Arnell P, Karlsson Y, Babbar A, Bergey F, Itzek A, Hyldegaard O, Norrby-Teglund A, Skrede S, INFECT Study Group. Risk Factors and Predictors of Mortality in Streptococcal Necrotizing Soft-tissue Infections: A Multicenter Prospective Study. Clin Infect Dis. 2021;72:293\u2013300.","journal-title":"Clin Infect Dis"},{"key":"3242_CR19","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.jss.2020.06.031","volume":"257","author":"AR McCarty","year":"2021","unstructured":"McCarty AR, Villarreal ME, Tamer R, Strassels SA, Schubauer KM, Paredes AZ, Santry H, Wisler JR. Analyzing Outcomes Among Older Adults With Necrotizing Soft-Tissue Infections in the United States. J Surg Res. 2021;257:107\u201317.","journal-title":"J Surg Res"},{"key":"3242_CR20","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1097\/TA.0000000000002636","volume":"89","author":"DL Horn","year":"2020","unstructured":"Horn DL, Shen J, Roberts E, Wang TN, Li KS, O\u2019Keefe GE, Cuschieri J, Bulger EM, Robinson BRH. Predictors of mortality, limb loss, and discharge disposition at admission among patients with necrotizing skin and soft tissue infections. J Trauma Acute Care Surg. 2020;89:186\u201391.","journal-title":"J Trauma Acute Care Surg"},{"key":"3242_CR21","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1007\/s00423-023-02929-x","volume":"408","author":"K Nagira","year":"2023","unstructured":"Nagira K, Ogoshi T, Akahori K, Enokida S, Enokida M, Ueda T, Homma M, Nagashima H. Factors associated with mortality in patients with extremity necrotizing soft-tissue infections: a single academic center experience. Langenbecks Arch Surg. 2023;408:189. https:\/\/doi.org\/10.1007\/s00423-023-02929-x.","journal-title":"Langenbecks Arch Surg"},{"key":"3242_CR22","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1007\/s00068-025-02835-5","volume":"51","author":"M Kariksiz","year":"2025","unstructured":"Kariksiz M, Ates O. Treatment and clinical outcomes in lower extremity necrotizing soft tissue infection. Eur J Trauma Emerg Surg. 2025;51:148. https:\/\/doi.org\/10.1007\/s00068-025-02835-5.","journal-title":"Eur J Trauma Emerg Surg"},{"key":"3242_CR23","doi-asserted-by":"publisher","first-page":"1535","DOI":"10.1097\/01.CCM.0000129486.35458.7D","volume":"32","author":"CH Wong","year":"2004","unstructured":"Wong CH, Khin LW, Heng KS, Tan KC, Low CO. The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections. Crit Care Med. 2004;32:1535\u201341.","journal-title":"Crit Care Med"},{"key":"3242_CR24","doi-asserted-by":"publisher","first-page":"910","DOI":"10.1097\/TA.0000000000004374","volume":"97","author":"DY Kim","year":"2024","unstructured":"Kim DY, Lavasile A, Kaji AH, Nahmias J, Grigorian A, Mukherjee K, Penaloza L, Posluszny J, Logan CD, Michelin E, Serena T, Sahr S, Bekdache K, Stoddard N, Choudhry A, Encalada RZ, Saltzman D, Padilla R, Truitt M, Grossman Verner H, Hunt D, Purvis V, Ross SW, Mallah MM, Dultz L, Kuhlenschmidt K, Mentzer CJ, Lonkar A, Chang G, Lemon B, de Virgilio C. Prospective derivation and validation of a necrotizing soft tissue infections score: An EASTmulticenter trial. J Trauma Acute Care Surg. 2024;97:910\u20137.","journal-title":"J Trauma Acute Care Surg"},{"key":"3242_CR25","doi-asserted-by":"publisher","first-page":"578","DOI":"10.1001\/jamadermatol.2017.0159","volume":"153","author":"DR Cranendonk","year":"2017","unstructured":"Cranendonk DR, van Vught LA, Wiewel MA, Cremer OL, Horn J, Bonten MJ, Schultz MJ, van der Poll T, Wiersinga WJ. Clinical Characteristics and Outcomes of Patients With Cellulitis Requiring Intensive Care. JAMA Dermatol. 2017;153:578\u201382.","journal-title":"JAMA Dermatol"},{"key":"3242_CR26","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1097\/BCR.0b013e318198a241","volume":"30","author":"TN Pham","year":"2009","unstructured":"Pham TN, Moore ML, Costa BA, Cuschieri J, Klein MB. Assessment of functional limitation after necrotizing soft tissue infection. J Burn Care Res. 2009;30:301\u20136.","journal-title":"J Burn Care Res"},{"key":"3242_CR27","doi-asserted-by":"publisher","first-page":"1506","DOI":"10.1007\/s00134-015-3916-9","volume":"41","author":"N de Prost","year":"2015","unstructured":"de Prost N, Sbidian E, Chosidow O, Brun-Buisson C, Amathieu R, Henri Mondor Hospital Necrotizing Fasciitis Group. Management of necrotizing soft tissue infections in the intensive care unit: results of an international survey. Intensive Care Med. 2015;41:1506\u20138.","journal-title":"Intensive Care Med"},{"key":"3242_CR28","first-page":"894","volume":"70","author":"EA McGillicuddy","year":"2011","unstructured":"McGillicuddy EA, Lischuk AW, Schuster KM, Kaplan LJ, Maung A, Lui FY, Bokhari SA, Davis KA. Development of a computed tomography-based scoring system for necrotizing soft-tissue infections. J Trauma. 2011;70:894\u20139.","journal-title":"J Trauma"},{"key":"3242_CR29","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1097\/TA.0000000000003183","volume":"91","author":"SC Brakenridge","year":"2021","unstructured":"Brakenridge SC, Wilfret DA, Maislin G, Andrade KE, Walker V, May AK, Dankner WM, Bulger EM. Resolution of organ dysfunction as a predictor of long-term survival in necrotizing soft tissue infections: Analysis of the AB103 Clinical Composite Endpoint Study in Necrotizing Soft Tissue Infections trial and a retrospective claims database-linked chart study. J Trauma Acute Care Surg. 2021;91:384\u201392.","journal-title":"J Trauma Acute Care Surg"},{"key":"3242_CR30","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1016\/j.ajem.2025.12.004","volume":"100","author":"\u0130 Altunok","year":"2025","unstructured":"Altunok \u0130, \u00d6zdemir S. Enhanced prognostic model for mortality in patients with Fournier gangrene: Validation of the Fournier gangrene mortality index and integration of platelet count and PCO\u2082. Am J Emerg Med. 2025;100:170\u20134.","journal-title":"Am J Emerg Med"},{"key":"3242_CR31","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","volume":"61","author":"E von Elm","year":"2008","unstructured":"von Elm E, Altman DG, Egger M, Pocock SJ, G\u00f8tzsche PC, Vandenbroucke JP, STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61:344\u20139.","journal-title":"J Clin Epidemiol"},{"key":"3242_CR32","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1186\/s13017-022-00406-2","volume":"17","author":"M Sartelli","year":"2022","unstructured":"Sartelli M, Coccolini F, Kluger Y, Agastra E, Abu-Zidan FM, Abbas AES, Ansaloni L, Adesunkanmi AK, Augustin G, Bala M, Baraket O, Biffl WL, Ceresoli M, Cerutti E, Chiara O, Cicuttin E, Chiarugi M, Coimbra R, Corsi D, Cortese F, Cui Y, Damaskos D, de\u2019Angelis N, Delibegovic S, Demetrashvili Z, De Simone B, de Jonge SW, Di Bella S, Di Saverio S, Duane TM, Fugazzola P, Galante JM, Ghnnam W, Gkiokas G, Gomes CA, Griffiths EA, Hardcastle TC, Hecker A, Herzog T, Karamarkovic A, Khokha V, Kim PK, Kim JI, Kirkpatrick AW, Kong V, Koshy RM, Inaba K, Isik A, Ivatury R, Labricciosa FM, Lee YY, Lepp\u00e4niemi A, Litvin A, Luppi D, Maier RV, Marinis A, Marwah S, Mesina C, Moore EE, Moore FA, Negoi I, Olaoye I, Ordo\u00f1ez CA, Ouadii M, Peitzman AB, Perrone G, Pintar T, Pipitone G, Podda M, Ra\u015fa K, Ribeiro J, Rodrigues G, Rubio-Perez I, Sall I, Sato N, Sawyer RG, Shelat VG, Sugrue M, Tarasconi A, Tolonen M, Viaggi B, Celotti A, Casella C, Pagani L, Dhingra S, Baiocchi GL, Catena F. WSES\/GAIS\/WSIS\/SIS-E\/AAST global clinical pathways for patients with skin and soft tissue infections. World J Emerg Surg. 2022;17:3. https:\/\/doi.org\/10.1186\/s13017-022-00406-2.","journal-title":"World J Emerg Surg"},{"key":"3242_CR33","doi-asserted-by":"publisher","unstructured":"Sartelli M, Coccolini F, Labricciosa FM, Al-Hasan MN, Buonomo L, Cheadle WG, De Simone B, Duane TM, Hardcastle TC, Hecker A, Kirkpatrick AW, Leone M, Martin-Loeches I, Marwah S, Maves RC, Montravers P, Podda M, Rello J, Tattevin P, Tessier J, Tran\u00e0 C, Ulrych J, Vallicelli C, Vigutto G, Watkins RR, Coimbra R, Catena F. Necrotizing soft-tissue infections survival guide in adult patients: A position statement by the Global Alliance for Infections in Surgery. J Trauma Acute Care Surg Epub 2025 Dec 17. https:\/\/doi.org\/10.1097\/TA.0000000000004833","DOI":"10.1097\/TA.0000000000004833"},{"key":"3242_CR34","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1097\/TA.0000000000001562","volume":"83","author":"MH Lauerman","year":"2017","unstructured":"Lauerman MH, Kolesnik O, Sethuraman K, Rabinowitz R, Joshi M, Clark E, Stein D, Scalea T, Henry S. Less is more? Antibiotic duration and outcomes in Fournier\u2019s gangrene. J Trauma Acute Care Surg. 2017;83:443\u20138.","journal-title":"J Trauma Acute Care Surg"},{"key":"3242_CR35","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/j.ijid.2020.10.019","volume":"102","author":"H Suzuki","year":"2021","unstructured":"Suzuki H, Muramatsu K, Kubo T, Kawasaki M, Fujitani T, Tsukamoto M, Uchida S, Fujino Y, Matsuda S, Sakai A. Factors associated with mortality among patients with necrotizing soft tissue infections: An analysis of 4597 cases using the Diagnosis Procedure Combination Database. Int J Infect Dis. 2021;102:73\u20138.","journal-title":"Int J Infect Dis"},{"key":"3242_CR36","doi-asserted-by":"publisher","first-page":"1189","DOI":"10.1007\/s00068-021-01706-z","volume":"48","author":"S van Stigt","year":"2022","unstructured":"van Stigt S, Knubben M, Schrooten T, Tan E. Prognostic factors for mortality in 123 severe cases of necrotizing fasciitis in 5 hospitals in the Netherlands between 2003 and 2017. Eur J Trauma Emerg Surg. 2022;48:1189\u201395.","journal-title":"Eur J Trauma Emerg Surg"},{"key":"3242_CR37","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1016\/j.cgh.2011.02.031","volume":"9","author":"AR Bonnel","year":"2011","unstructured":"Bonnel AR, Bunchorntavakul C, Reddy KR. Immune dysfunction and infections in patients with cirrhosis. Clin Gastroenterol Hepatol. 2011;9:727\u201338.","journal-title":"Clin Gastroenterol Hepatol"},{"key":"3242_CR38","doi-asserted-by":"publisher","first-page":"1385","DOI":"10.1016\/j.jhep.2014.08.010","volume":"61","author":"A Albillos","year":"2014","unstructured":"Albillos A, Lario M, \u00c1lvarez-Mon M. Cirrhosis-associated immune dysfunction: distinctive features and clinical relevance. J Hepatol. 2014;61:1385\u201396.","journal-title":"J Hepatol"},{"key":"3242_CR39","doi-asserted-by":"publisher","unstructured":"Bartoletti M, Giannella M, Lewis R, Caraceni P, Tedeschi S, Paul M, Schramm C, Bruns T, Merli M, Cobos-Trigueros N, Seminari E, Retamar P, Mu\u00f1oz P, Tumbarello M, Burra P, Torrani Cerenzia M, Barsic B, Calbo E, Maraolo AE, Petrosillo N, Galan-Ladero MA, D\u2019Offizi G, Bar Sinai N, Rodr\u00edguez-Ba\u00f1o J, Verucchi G, Bernardi M, Viale P. ESGBIS\/BICHROME Study Group. A prospective multicentre study of the epidemiology and outcomes of bloodstream infection in cirrhotic patients. Clin Microbiol Infect. 2018;24:546.e1-546.e8. https:\/\/doi.org\/10.1016\/j.cmi.2017.08.001","DOI":"10.1016\/j.cmi.2017.08.001"},{"key":"3242_CR40","doi-asserted-by":"publisher","first-page":"4805","DOI":"10.1007\/s00068-022-02011-z","volume":"48","author":"SFL van Stigt","year":"2022","unstructured":"van Stigt SFL, Schrooten TKJ, Knubben M, Tan ECTH. Impact of severe necrotizing fasciitis on quality of life in the Netherlands. Eur J Trauma Emerg Surg. 2022;48:4805\u201311.","journal-title":"Eur J Trauma Emerg Surg"},{"key":"3242_CR41","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1186\/s13613-021-00891-9","volume":"11","author":"T Urbina","year":"2021","unstructured":"Urbina T, Canoui-Poitrine F, Hua C, Layese R, Alves A, Ouedraogo R, Bosc R, Sbidian E, Chosidow O, Dessap AM, de Prost N, Henri Mondor Hospital Necrotizing Fasciitis Group. Long-term quality of life in necrotizing soft-tissue infection survivors: a monocentric prospective cohort study. Ann Intensive Care. 2021;11:102. https:\/\/doi.org\/10.1186\/s13613-021-00891-9.","journal-title":"Ann Intensive Care"},{"key":"3242_CR42","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1089\/sur.2023.184","volume":"24","author":"F Nawijn","year":"2023","unstructured":"Nawijn F, Kerckhoffs MC, Hietbrink F. Quality of Life After Intensive Care Unit Admittance for Necrotizing Soft Tissue Infections Is Deemed Acceptable for Patients. Surg Infect (Larchmt). 2023;24:924\u20139.","journal-title":"Surg Infect (Larchmt)"}],"container-title":["European Journal of Trauma and Emergency Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00068-026-03242-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00068-026-03242-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00068-026-03242-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T06:19:10Z","timestamp":1781245150000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00068-026-03242-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,12]]},"references-count":42,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3242"],"URL":"https:\/\/doi.org\/10.1007\/s00068-026-03242-0","relation":{},"ISSN":["1863-9941"],"issn-type":[{"value":"1863-9941","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,12]]},"assertion":[{"value":"4 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Institutional Review Board (IRB) of the University of Cagliari (P.I. Centre) and the IRBs of the other participating centres. Formal approval by the Ethics Committee was deemed unnecessary due to the non-interventional, non-experimental design of the study. The study was conducted in accordance with the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"All patients had previously provided written consent for the use of their anonymized clinical data for research purposes, in accordance with national regulations and the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"187"}}