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University of Maryland Medical Center is a referral center for patients with necrotizing fasciitis in the region, as we have a major hyperbaric chamber, and a specialized Soft Tissue Surgery team. Therefore, patients with soft tissue infection make up a group with frequent transferring to UMMC.
Some of the factors, from recent meta-analysis, suggest higher rate of mortality among this particular group of patients. When they display these factors, which are also consistent with our clinical observations, we should be more aggressive with their treatment:
Acute kidney injury OR 3.23 (2.76–5.04)
Bacteremia OR 3.89 (1.39–10.85)
Hypotension OR 1.97 (1.26–3.10)
Coagulopathy OR 2.81 (1.23–6.40)
References
Kruger N, Durr K, Fernando SM, Rochwerg B, Inaba K, Kim D, Yadav K, Kubelik D, Engels PT, Glen P, Tran A. Prognostic Factors Associated With Mortality Among Patients With Necrotizing Soft-Tissue Infection: A Systematic Review and Meta-Analysis. Crit Care Med. 2026 Jul 1;54(7):1779-1787. doi: 10.1097/CCM.0000000000007147. Epub 2026 May 15. PMID: 42138515.