FACTORS AFFECTING MORTALITY OF FOURNIER’S GANGRENE: REVIEW OF 70 PATIENTS

Authors

  • Ahmet Ersay,

    Corresponding author
    1. Departments of * Urology,General Surgery and Biostatistics, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
      Professor Yılmaz Akgün, Department of General Surgery, Faculty of Medicine, Dicle University, 21280 Diyarbakir, Turkey.
      Email: yakgun@dicle.edu.tr
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      A. Ersay MD
  • Gulsen Yilmaz,

    1. Departments of * Urology,General Surgery and Biostatistics, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
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      G. Yilmaz MD
  • Yilmaz Akgun,

    1. Departments of * Urology,General Surgery and Biostatistics, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
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      Y. Akgun
  • Yusuf Celik

    1. Departments of * Urology,General Surgery and Biostatistics, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
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      Y. Celik PhD.

  • A. Ersay MD; G. Yilmaz MD; Y. Akgun; Y. Celik PhD.

Professor Yılmaz Akgün, Department of General Surgery, Faculty of Medicine, Dicle University, 21280 Diyarbakir, Turkey.
Email: yakgun@dicle.edu.tr

Abstract

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.

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