Fournier’s gangrene: an analysis of 80 patients and a novel scoring system

• Published in: Techniques in coloproctology Vol. 14; no. 3; pp. 217 - 223
• Main Authors: Yilmazlar, T., Ozturk, E., Ozguc, H., Ercan, I., Vuruskan, H., Oktay, B.
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01.09.2010; Springer Nature B.V
• Subjects: Abdominal Surgery; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - administration & dosage; APACHE; Cause of Death; Colorectal Surgery; Combined Modality Therapy; Databases, Factual; Female; Follow-Up Studies; Fournier Gangrene - diagnosis; Fournier Gangrene - mortality; Fournier Gangrene - therapy; Gastroenterology; Genital Diseases, Female - diagnosis; Genital Diseases, Female - mortality; Genital Diseases, Female - therapy; Genital Diseases, Male - diagnosis; Genital Diseases, Male - mortality; Genital Diseases, Male - therapy; Humans; Logistic Models; Male; Medicine; Medicine & Public Health; Middle Aged; Multivariate Analysis; Original Article; Proctology; Retrospective Studies; ROC Curve; Severity of Illness Index; Surgery; Surgical Procedures, Operative - methods; Survival Analysis; Treatment Outcome; Young Adult; Severity index; Fournier’s gangrene; Mortality; Dissemination
• ISSN: 1123-6337; 1128-045X
• DOI: 10.1007/s10151-010-0592-1

Background To create a better scoring system for outcome prediction for patients with Fournier’s gangrene in order to design more appropriate and feasible management strategies. Methods Using logistic regression, the medical records of 80 patients who underwent surgery for Fournier’s gangrene in the last 10 years were reviewed using a prospectively maintained database, and a novel scoring system was adopted combining this data with the Fournier’s gangrene severity index (FGSI). The new system consists of a physiological score, an age score, and an extent of gangrene score. Results The mortality rate of the 80 patients was 21%. Using the new scoring system (UFGSI), at a threshold value of 9, there was a 94% probability of death with a score greater than 9 and an 81% probability of survival with a score of 9 or less ( P  < 0.001). The receiver operating characteristics (ROC) analysis concluded that the new scoring system was more powerful than the FGSI ( P  = 0.002). Conclusions The power of the novel scoring system introduced in this study proves that in patients with Fournier’s gangrene, the extent of the gangrene as well as the patient’s age and physiological status have a significant effect on the outcome.