The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.
Prognostic Aspects, Survival Rate, and Predisposing Risk Factors in Patients with Fournier's Gangrene and Necrotizing Soft Tissue Infections: Evaluation of Clinical Outcome of 55 Patients
Abstract
Objective: To determine predisposing or prognostic factors and mortality rates of patients with Fournier’s gangrene compared to other necrotizing soft tissue infections (NSTI). Material and Methods: Data of 55 intensive care patients (1981–2010) with NSTI were evaluated. Data were collected prospectively. Results: 43.4% of the patients were in septic condition and 27.3% were hemodynamically unstable. Half of the patients showed predisposing factors (52.7%). The lower extremity (63.2%), abdomen (30.9%), and perineum (14.5%) were most affected. Polymicrobial infections were frequent (65.5%, mean 2.8, range: 1–4). The mortality rate was 16.4% (n = 9). An increase was shown for diabetes mellitus (20%), cardiac insufficiency (22.3%), septic condition at presentation (33.3%), abdominal affection (47.1%), and hemodynamic instability (46.7%). Comparing survivors and nonsurvivors, statistical significance was seen with age (p < 0.001), septic condition at admission (p < 0.001), hemodynamic instability (p < 0.001), low blood pressure (p < 0.001), and abdominal affection (p < 0.001). In laboratory findings, an increase of creatine kinase (p < 0.001) and lactate (p < 0.001) and a decrease of antithrombin III (p < 0.007) and the Quick value (p < 0.01) proved to be significant. Conclusion: Patients with Fournier’s gangrene do not differ in all aspects from those with other NSTI. Successful treatment consists of immediate surgical debridement, broad-spectrum antibiotic treatment, and critical care management. Supportive hyperbaric oxygen therapy should be considered.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“At the time of admission, 52.7% of the patients received controlled respiration, 43.6% were already septic, and 27.3% showed hemodynamic instability, necessitating the application of vasopressors.”
§ Prognostic Aspects, Survival Rate, and Predisposing Risk Factors in Patients with Fournier's Gangrene and Necrotizing Soft Tissue Infections: Evaluation of Clinical Outcome of 55 Patients > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“An increase in the mortality rate could be seen in patients with diabetes mellitus (20%), cardiac insufficiency (22.3%), a septic condition at presentation (33.3%), muscular involvement (38.9%), and above all if the abdomen was affected (47.1%) or the disease had already caused hemodynamic instability (46.7%).”
§ Prognostic Aspects, Survival Rate, and Predisposing Risk Factors in Patients with Fournier's Gangrene and Necrotizing Soft Tissue Infections: Evaluation of Clinical Outcome of 55 Patients > Results
hedgedstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Patients with Fournier's gangrene did not show significant differences concerning any item compared to other localizations of NSTI ( table 1 ).”
§ Prognostic Aspects, Survival Rate, and Predisposing Risk Factors in Patients with Fournier's Gangrene and Necrotizing Soft Tissue Infections: Evaluation of Clinical Outcome of 55 Patients > Results
plainn = 8 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The typical crepitation was found in 73.6% of all cases.”
§ Prognostic Aspects, Survival Rate, and Predisposing Risk Factors in Patients with Fournier's Gangrene and Necrotizing Soft Tissue Infections: Evaluation of Clinical Outcome of 55 Patients > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Approximately half (52.7%) of the patients showed predisposing factors, about a third (32.7%) of the patients had a cardiac insufficiency NYHA II and higher, and 27.3 and 25.4% suffered from diabetes mellitus and hypertension, respectively.”
§ Prognostic Aspects, Survival Rate, and Predisposing Risk Factors in Patients with Fournier's Gangrene and Necrotizing Soft Tissue Infections: Evaluation of Clinical Outcome of 55 Patients > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ Prognostic Aspects, Survival Rate, and Predisposing Risk Factors in Patients with Fournier's Gangrene and Necrotizing Soft Tissue Infections: Evaluation of Clinical Outcome of 55 Patients > Results
“muscular involvement (77.8 vs. 4.34%, p ! 0.001).”
§ Prognostic Aspects, Survival Rate, and Predisposing Risk Factors in Patients with Fournier's Gangrene and Necrotizing Soft Tissue Infections: Evaluation of Clinical Outcome of 55 Patients > Conclusion
“Muscular affection | 32.7% | n = 18”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“Hemodynamically unstable 27.3% | n = 15 | 20.0% | n = 2 | 27.6% | n = 13 | n.s. | |”
§ Prognostic Aspects, Survival Rate, and Predisposing Risk Factors in Patients with Fournier's Gangrene and Necrotizing Soft Tissue Infections: Evaluation of Clinical Outcome of 55 Patients > Conclusion
Reported 20 · recomputed 25
Citations
Cites
Wong, C.-H., Khin, L.-W., Heng, K.-S., Tan, K.-C., & Low, C.-O. (2004) · Critical Care Medicine · doi:10.1097/01.ccm.0000129486.35458.7d · Cited by 1,611
Determinants of Mortality for Necrotizing Soft-Tissue Infections
McHenry, C. R., Piotrowski, J. J., Petrinic, D., & Malangoni, M. A. (1995) · Annals of Surgery · doi:10.1097/00000658-199505000-00013 · Cited by 888
Necrotizing Soft-Tissue Infection: Diagnosis and Management
Goldstein, E. J. C., Anaya, D. A., & Dellinger, E. P. (2007) · Clinical Infectious Diseases · doi:10.1086/511638 · Cited by 862
Fournier's gangrene: a review of 1726 cases
Eke, N. (2000) · Journal of British Surgery · doi:10.1046/j.1365-2168.2000.01497.x · Cited by 813
The ACCP-SCCM Consensus Conference on Sepsis and Organ Failure
Bone, R. C., Sibbald, W. J., & Sprung, C. L. (1992) · Chest · doi:10.1378/chest.101.6.1481 · Cited by 738
HEMOLYTIC STREPTOCOCCUS GANGRENE
MELENEY, F. L. (1924) · Archives of Surgery · doi:10.1001/archsurg.1924.01120080083007 · Cited by 586
Kaul, R., McGeer, A., Low, D. E., Green, K., Schwartz, B., & Simor, A. E. (1997) · The American Journal of Medicine · doi:10.1016/s0002-9343(97)00160-5 · Cited by 517
A Clinical and Experimental Study
PETERS, R. M., LORING, W. E., & SPRUNT, W. H. (1958) · Annals of Surgery · doi:10.1097/00000658-195812000-00002 · Cited by 502
Hyperbaric oxygen therapy for necrotizing fasciitis reduces mortality and the need for debridements.
Riseman, J., Zamboni, W., Curtis, A., Graham, D., Konrad, H., & Ross, D. (1990) · Surgery · doi:10.5555/uri:pii:003960609090280f · Cited by 423
Hyperbaric oxygen therapy for necrotizing fasciitis reduces mortality and the need for debridements.
Riseman, J., Zamboni, W. A., Curtis, A. B., et al. (1990) · PubMed · Cited by 411
Research works printed but not linked: 1
- 10.1097%2F00005392-199709000-00039 · DOI
Cited by
Items 101–104 of 104
(2000) · Time to knit · doi:10.1016/s1762-0953(20)42422-7
Fournier's gangrene in a single-center experience: a retrospective analysis of 23 cases
Çınar, H., Akdağ, A., Özgen, U., et al. (2025) · Pamukkale Medical Journal · doi:10.31362/patd.1737766
Aschwanden, F., Wimmer, L., Müssgens, C., Sigg, S., Affentranger, A., Kaufmann, B. C., Mattei, A., Bertschy, S., Egli, A., Fankhauser, C. D., et al. (2026) · Research Square · doi:10.21203/rs.3.rs-8829364/v1
Karahan, M., Hacıalioğlu, C., Kaya, S., et al. (2026) · Frontiers in Surgery · doi:10.3389/fsurg.2026.1793103
“An average of 2–4 debridement sessions are reported in the literature (8, 9).”
Metadata
- Authors
- Martinschek, A., Evers, B., Lampl, L., Gerngroß, H., Schmidt, R., & Sparwasser, C.
- Affiliations
- Bundeswehrkrankenhaus Ulm (DE)
- ORCID
- Martinschek, A.
- Venue
- Urologia Internationalis
- Publisher
- S. Karger AG
- Published
- 2012
- Volume
- 89
- Issue
- 2
- Pages
- 173-179
- ISSN
- 0042-1138 (ISSN-L)
- 1423-0399
- OpenAlex
- W1979554200
- Semantic Scholar
- e5487587818a3f1ecfcbcd142e1edb8aee7bbc80
- Cited by
- 112
- References
- 30
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 8 · 2023: 11 · 2022: 4 · 2021: 11 · 2020: 7 · 2019: 7 · 2018: 14 · 2017: 11 · 2016: 9 · 2015: 9 · 2014: 6 · 2013: 4
- FWCI
- 4.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- karger.com/pages/terms-and-conditions (vor)
- karger.com/pages/terms-and-conditions (tdm)
- Locations
- Urologia Internationalis (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Streptococcal Infections and Treatments
- Health Sciences › Medicine › Infectious Diseases › Otolaryngology and Infectious Diseases
- Health Sciences › Medicine › Infectious Diseases › Clostridium difficile and Clostridium perfringens research
- Keywords
- Fournier's gangrene, necrotizing soft tissue infection, prognostic factors, mortality, risk factors, sepsis, hemodynamic instability, co-infection, diabetes mellitus, heart failure, abdominal involvement, perineal infection, creatine kinase, lactate, antithrombin III, hyperbaric oxygen therapy, surgical debridement, intensive care
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents, Critical Care, Debridement, Female, Hemodynamics, Humans, Hyperbaric Oxygenation, Male, Middle Aged, Necrosis, Prospective Studies, Risk Factors, Survival Rate, Treatment Outcome, Soft Tissue Infections, Fournier Gangrene, Coinfection
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