The importance of the scoring system in Fournier's gangrene

Ulus Travma Acil Cerrahi Derg. 2022 Dec;29(1):109-115. doi: 10.14744/tjtes.2022.42738.

Abstract

Background: The objective of the study was to investigate risk factors affecting mortality rates in patients with Fournier's gangrene (FG) and develop methods to increase the survival rate.

Methods: We collected data of 73 patients treated for FG between February 2012 and June 2021 at Istanbul Professor Doctor Cemil Taşçıoğlu City Hospital General Surgery Clinic. The data of living patients (Group 1, n=56) and deceased patients (Group 2, n=17) were analyzed separately. Demographic data of patients were sex, age, infection rate, Uludag FG severity index (UFGSI) scores and FG severity index (FGSI) scores, urea serum levels, the source of infection, the presence of diabetes, obesity, the presence of diversion stoma, duration of vacuum-assisted closure treatment in days, hospitalization time in days, intensive care period in days, and isolated bacterial species.

Results: The mortality rate was 23%. A significant difference in age and dissemination score of the infection was found between the two groups. According to UFGSI and FGSI scores, the scores of the two groups of patients were significantly higher. The UFGSI had 100% sensitivity and 68% sensitivity. FGSI had 82% sensitivity and 58% specificity. The cutoff values for UFGSI and FGSI were 8 and 6, respectively.

Conclusion: Age and dissemination scores of diseases were important factors that cause mortality in patients with FG. However, an accurate scoring system is important in predicting patients to be treated in the intensive care unit (ICU). Patients with a UFGSI score above 8 face a higher risk of death and should be treated in the ICU.

MeSH terms

  • Critical Care
  • Diabetes Mellitus*
  • Fournier Gangrene* / diagnosis
  • Fournier Gangrene* / therapy
  • Humans
  • Intensive Care Units
  • Male
  • Retrospective Studies
  • Severity of Illness Index
  • Survival Rate