• Andreas Krieg, Levent Dizdar, Pablo Emilio Verde, and Wolfram Trudo Knoefel.
• Department of Surgery (A), Heinrich-Heine-University and University Hospital Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany, andreas.krieg@med.uni-duesseldorf.de.
• Langenbecks Arch Surg. 2014 Mar 1; 399 (3): 333-41.

PurposeNecrotizing 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.MethodsThe 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.ResultsSixty-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.ConclusionIn 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.

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