Open AccessRisk Factors and Interventions: Fournier Gangrene in a Tertiary Hospital: A 10-year Experience
Author(s) -
Sylvia Karina L. Alip,
Marie Carmela Lapitan
Publication year - 2022
Publication title -
acta medica philippina/acta medica philippina
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.128
H-Index - 4
eISSN - 2094-9278
pISSN - 0001-6071
DOI - 10.47895/amp.v56i6.3991
Subject(s) - medicine , gangrene , comorbidity , diabetes mellitus , surgery , creatinine , population , mortality rate , white blood cell , concomitant , retrospective cohort study , environmental health , endocrinology
Objective. The study aimed to describe the patient demographic characteristics, clinical factors, surgical interventions, and quality of care parameters in non-survivors and survivors of Fournier’s gangrene (FG).
Methods. A total of 131 cases of Fournier’s gangrene (FG) were included in a retrospective chart review in the Philippine General Hospital over 10 years using the Department of Surgery research database. We collected data for various direct and derived variables from the identified population. The primary outcome was mortality rate, while other factors studied were genital and colorectal manipulation, bowel diversion, laboratory parameters (white blood cell count, creatinine, hemoglobin).
Results. The mortality rate was 15%. Diabetes mellitus was common comorbidity among patients with Fournier’s disease. The following were statistically more common in the non-survivor group: female sex, concomitant bowel diversion surgery. Admission data in the non-survivor group showed a lower serum hemoglobin, a higher serum creatinine, and an increased percentage of patients with an abnormal white blood cell count; these did not statistically differ between cohorts, however. The median time to first antibiotic infusion was six hours. The median time to surgery was 13 hours.
Conclusions. Among patients with Fournier’s gangrene, the proportion of women and those undergoing bowel diversion was higher in those who did not survive. The time of infusion of antibiotics or time to surgery did not differ significantly between survivors and non-survivors.