title: Predictors of mortality for necrotizing soft-tissue infections: a retrospective analysis of 64 cases.
abstract: OBJECTIVE
  Necrotizing soft-tissue infection (NSTI) is a rare, but rapidly progressive and life-threatening disease with a high morbidity and mortality. The aim of the present study was to evaluate predictors of mortality in a group of patients with NSTIs treated at a single center.
  
  
  METHODS
  The medical records of all patients that were treated because of a NSTI at our department between 1996 and 2011 were retrospectively analyzed. To identify factors that were associated with patients' outcome variables including demographic, clinical, laboratory, and microbiologic parameters were compared between the group of survivors and non-survivors.
  
  
  RESULTS
  Sixty-four patients with the diagnosis of a NSTI were identified. The overall mortality was 32.8 %. Multiple regression analyses identified the development of a renal failure during the hospital stay and more importantly, the presence of visible skin necrosis on the initial clinical examination as independent prognostic markers for NSTIs.
  
  
  CONCLUSIONS
  In patients with NSTIs, skin necrosis may serve as an indicator for an advanced stage of the disease. Thus, the presence of visible skin necrosis as an independent predictor of mortality emphasizes the outstanding importance of early diagnosis and prompt treatment to improve the prognosis of patients with NSTIs.
authors.affiliation: Department of Surgery (A), Heinrich-Heine-University and University Hospital Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany, andreas.krieg@med.uni-duesseldorf.de.
authors.forename: Andreas
authors.initials: A
authors.lastname: Krieg
authors.forename: Levent
authors.initials: L
authors.lastname: Dizdar
authors.forename: Pablo Emilio
authors.initials: PE
authors.lastname: Verde
authors.forename: Wolfram Trudo
authors.initials: WT
authors.lastname: Knoefel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019115:Fasciitis, Necrotizing / Q000382:microbiology / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D012189:Retrospective Studies; D012307:Risk Factors; D012867:Skin / Q000473:pathology; D018461:Soft Tissue Infections / Q000382:microbiology / Q000401:mortality* / Q000473:pathology; D015996:Survival Rate; D055815:Young Adult