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FACTORS AFFECTING MORTALITY OF FOURNIER’S GANGRENE: REVIEW OF 70 PATIENTS
Author(s) -
Ersay Ahmet,
Yilmaz Gulsen,
Akgun Yilmaz,
Celik Yusuf
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2006.03975.x
Subject(s) - medicine , gangrene , perineum , fournier gangrene , scrotum , surgery , logistic regression , fascia , retrospective cohort study , fasciitis , necrotising fasciitis
Background: Fournier’s disease is a potentially fatal, acute, gangrenous infection of the scrotum, penis or perineum associated with a synergistic bacterial infection of the subcutaneous fat and superficial fascia. Methods: The clinical records of 70 patients treated for Fournier’s gangrene were evaluated retrospectively to determine prognostic indices and to stress Fournier’s Severity Index (FSI), influencing outcome. Results: The mortality rate in this study was 22.8%. Length of the hospitalization time and FSI were detected as effective factors on mortality of Fournier’s gangrene ( P < 0.05) by Binary Logistic Regression analysis and the area under the receiver operating characteristic curve of these variables was also found to be significant ( P < 0.001). The average FSI was determined as 4.66 ± 2.31 in survivors and 11.56 ± 2.68 in non‐survivors and 5.11 ± 2.83 in patients with primary genito‐urinary infection but 7.56 ± 4.35 in primary anorectal infection. The FSI was also found predictive of hospitalization time and number of debridements among survivors. Conclusion: Fournier’s Severity Index is a simplified way of comparing patients with this disease and may also have some significance in predicting outcome. The FSI is a more significant and predictive tool that should be popularized to predict the prognosis in Fournier’s gangrene.