Scoring Systems for the Prediction of Mortality in Patient with Fournier's Gangrene: an Analysis of 60 Patients


Usta M. A. , Ulusahin M. , Tayar S. , Çekiç A. B. , Kazaz İ. O. , Güner A. , ...More

INDIAN JOURNAL OF SURGERY, 2020 (Journal Indexed in SCI) identifier

  • Publication Type: Article / Article
  • Volume:
  • Publication Date: 2020
  • Doi Number: 10.1007/s12262-020-02421-6
  • Title of Journal : INDIAN JOURNAL OF SURGERY

Abstract

The aim of this study was to evaluate demographic and clinical findings in Fournier's gangrene and to assess feasibility of several scoring indexes for predicting morbidity and mortality. Patients who underwent surgery for Fournier's gangrene between 2006 and 2020 were analyzed. Scores of Fournier Gangrene Severity Index, Uludag Fournier Gangrene Severity Index, Age-adjusted Charlson Comorbidity Index, and Sequential Organ Failure System for each patient were calculated. Mortality rate was regarded as the primary outcome. There were 60 patients with a mean age of 61.4 SD 16.0 years. There were 10 deaths with a mortality rate of 16.7%. There were significant differences between non-survivor (n = 10) and survivor patients (n = 50) with regard to hemoglobin, serum total protein, and serum bicarbonate levels (p < 0.05). In all patients who survived, the scores of all indexes were significantly higher than that of the patients who were non-survivors (p < 0.05). Although the diagnostic accuracy of Fournier Gangrene Severity Index and Uludag Fournier Gangrene Severity Index for mortality was moderate, diagnostic accuracies of Age-adjusted Charlson Comorbidity Index and Sequential Organ Failure System score for prediction of mortality were regarded as good. Fournier Gangrene Severity Index, Uludag Fournier Gangrene Severity Index, Age-adjusted Charlson Comorbidity Index, and Sequential Organ Failure System score were shown to be associated with mortality in Fournier's gangrene. Diagnostic accuracies of Uludag Fournier Gangrene Severity Index, Age-adjusted Charlson Comorbidity Index, and Sequential Organ Failure System score for prediction of mortality were higher than that of Fournier Gangrene Severity Index.