Volume 62, Issue 2 pp. 272-279
Special Article

Necrotizing soft tissue infections – a multicentre, prospective observational study (INFECT): protocol and statistical analysis plan

M. B. Madsen

Corresponding Author

M. B. Madsen

Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

Correspondence

M. B. Madsen, Department of Intensive Care 4131, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark

E-mail: [email protected]

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S. Skrede

S. Skrede

Department of Medicine, Haukeland University Hospital, Bergen, Norway

Department of Clinical Science, University of Bergen, Bergen, Norway

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T. Bruun

T. Bruun

Department of Medicine, Haukeland University Hospital, Bergen, Norway

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P. Arnell

P. Arnell

Department of Anaesthesia and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden

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A. Rosén

A. Rosén

Department of Anaesthesia and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden

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M. Nekludov

M. Nekludov

Department of Anaesthesia, Surgical Services and Intensive Care, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

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Y. Karlsson

Y. Karlsson

Department of Anaesthesiology and Intensive Care, Blekinge County Hospital, Karlskrona, Sweden

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F. Bergey

F. Bergey

LifeGlimmer GmBH, Berlin, Germany

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E. Saccenti

E. Saccenti

Laboratory of Systems and Synthetic Biology, Wageningen University & Research, Wageningen, the Netherlands

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V. A. P. Martins dos Santos

V. A. P. Martins dos Santos

LifeGlimmer GmBH, Berlin, Germany

Laboratory of Systems and Synthetic Biology, Wageningen University & Research, Wageningen, the Netherlands

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A. Perner

A. Perner

Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

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A. Norrby-Teglund

A. Norrby-Teglund

Centre for Infectious Medicine, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden

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O. Hyldegaard

O. Hyldegaard

Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

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First published: 29 October 2017
Citations: 33

Conflicts of interest

The Department of Intensive Care, Rigshospitalet, receives support for research from CSL Behring, Ferring Pharmaceuticals and Fresenius Kabi, but the authors would like to emphasize that the support has not been used as contribution to this study.

Funding

The study is supported by the European Union's Seventh Framework Programme under the grant agreement 305340.

Abstract

Background

The INFECT project aims to advance our understanding of the pathophysiological mechanisms in necrotizing soft tissue infections (NSTIs). The INFECT observational study is part of the INFECT project with the aim of studying the clinical profile of patients with NSTIs and correlating these to patient-important outcomes. With this protocol and statistical analysis plan we describe the methods used to obtain data and the details of the planned analyses.

Methods

The INFECT study is a multicentre, prospective observational cohort study. Patients with NSTIs are enrolled in five Scandinavian hospitals, which are all referral centres for NSTIs. The primary outcomes are the descriptive variables of the patients. Secondary outcomes include identification of factors associated with 90-day mortality and amputation; associations between affected body part, maximum skin defect and Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score and 90-day mortality; 90-day mortality in patients with and without acute kidney injury (AKI) and LRINEC score of six and above or below six; and association between affected body part at arrival and microbiological findings. Exploratory outcomes include univariate analyses of baseline characteristics associations with 90-day mortality. The statistical analyses will be conducted in accordance with the predefined statistical analysis plan.

Conclusion

Necrotizing soft tissue infections result in severe morbidity and mortality. The INFECT study will be the largest prospective study in patients with NSTIs to date and will provide important data for clinicians, researchers and policy makers on the characteristics and outcomes of these patients.

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