Role of C-Reactive Protein/Lymphocyte and Neutrophil/Lymphocyte Ratios in Predicting Mortality in Patients with Fournier’s Gangrene

Abstract

Background and objectives Fournier’s gangrene (FG) is a polymicrobial-induced necrotizing fasciitis that affects the deep and superficial tissues of the perineal, perianal, scrotal, and genital regions. This study aimed to investigate the role of C-reactive protein (CRP)/lymphocyte and neutrophil/lymphocyte ratios, which are objective markers of inflammatory response, in predicting mortality in patients with FG.Patients and methods Seventy-one patients who underwent surgery for FG between 2019 and 2023 were evaluated retrospectively. Demographic and clinical characteristics, laboratory results, the FG severity index (FGSI) score, and the CRP/lymphocyte and neutrophil/lymphocyte ratios were analyzed for the patient groups with and without in-hospital mortality.Results The characteristics of the patients with and without mortality were compared. A total of 71 patients, 51 (71.8%) males and 20 (28.2%) females, were evaluated. Eight patients died during treatment. The median age was 67 (56–86) years in the mortality group and 58 (27–82) years in the non-mortality group. Statistically significant differences were observed between the two groups in terms of age, lymphocyte count, CRP/lymphocyte, neutrophil/lymphocyte, potassium, blood urea nitrogen, and FSGI. In the receiver operating characteristic analysis of the CRP/lymphocyte and neutrophil/lymphocyte ratios, the cutoff values were calculated as 183.3 and 19.93, respectively. By comparing the data between the mortality and non-mortality groups, the sensitivity and specificity rates of these ratios were also determined.Conclusion The CRP/lymphocyte and neutrophil/lymphocyte ratios may be important parameters in predicting mortality in patients with FG.

Keywords

• C-reactive protein
• Fournier’s gangrene
• lymphocyte
• neutrophil