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Validation and simplification of F ournier's gangrene severity index
Author(s) -
Lin TsungYen,
Ou ChienHui,
Tzai TzongShin,
Tong YatChing,
Chang ChienChen,
Cheng HongLin,
Yang WenHorng,
Lin YungMing
Publication year - 2014
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.12426
Subject(s) - medicine , hematocrit , creatinine , white blood cell , gangrene , renal function , mortality rate , sepsis , gastroenterology , hypokalemia , surgery
Objectives To validate the predictive value of F ournier's G angrene S everity I ndex in patients with F ournier gangrene and to facilitate patient mortality risk‐stratification by simplifying the F ournier's G angrene S everity I ndex. Methods From J anuary 1989 to D ecember 2011, 85 male patients with clinically‐documented F ournier's gangrene undergoing intensive treatment and with complete medical records were recruited. The demographic information and nine parameters of F ournier's G angrene S everity I ndex were compared between survivors and non‐survivors. The parameters that showed a significant difference between the two groups were selected to generate a simplified scoring index. Results Of the 85 patients recruited, 16 patients died of the disease with mortality rate of 18.8%. The F ournier's G angrene S everity I ndex score at initial diagnosis was significantly higher in non‐survivors than in survivors. Of the nine parameters of F ournier's G angrene S everity I ndex, the scores of serum creatinine level, hematocrit level and serum potassium level were significantly different between the two groups. However, the mean body temperatures, heart rate, respiration rate, white blood cell count, serum sodium and bicarbonate levels were non‐significantly different. Of the 12 patients with chronic kidney disease or end‐stage renal disease, 10 died of severe sepsis. A simplified scoring index including parameters of creatinine, hematocrit and potassium was generated, which provided sensitivity and specificity of 87% and 77% in predicting patient mortality, respectively. The predictive values of this simplified F ournier's G angrene S everity I ndex were shown to be non‐inferior to F ournier's G angrene S everity I ndex in our patients. Conclusions The simplified F ournier's G angrene S everity I ndex is easy to use at initial diagnosis, and offers a way to compare outcomes in different clinical populations.