Four Determinative Factors in Fournier’s Gangrene Mortality

Abstract

Aim: We aimed to more accurately predict mortality in Fournier’s gangrene (FG) by investigating factors affecting mortality such as age, extent of infection, presence of accompanying comorbidities, the intensive care unit (ICU) length of stay (LOS). Method: Routinely recorded data of 37 FG patients treated between February 2012-May 2018 were retrospectively evaluated. The patients were divided in two groups as the deceased group (DG) (n=10) and surviving group (SG) (n=27) and compared in terms of sex, age score (AS), dissemination score (DS), Uludağ Fournier’s gangrene severity index (UFGSI) score, Fournier gangrene severity index (FGSI) score, serum urea levels, presence of diabetes and obesity, presence of comorbidities other than diabetes and obesity (COTDO), presence of diversion colostomy, number of days of vacuum-assisted closure treatment, hospital LOS, ICU LOS, and species of isolated bacteria. Associations between mortality and factors such as age, DS, COTDO, and ICU LOS were investigated in all cases. Results: There was a significant difference between the two groups in terms of AS. DS was significantly higher in the DG than in SG. All of the patients in the DG had COTDO, while only 13 of the patients in the SG had these comorbidities, and the difference between the two groups was statistically significant. ICU LOS was significantly higher in the MG. In reciever operator characteristics curve analysis, UFGSI and FGSI had 93% specificity and 90% and 70% sensitivity, respectively. In logistic regression analysis, age, DS, COTDO, and ICU LOS were independent predictive factors associated with mortality. Conclusion: Age, DS, COTDO, and ICU LOS showed significant differences between deceased and surviving patients, and emerged as independent predictive factors associated with mortality. As a result, these factors have been shown to be determinative factors in FG mortality.

Keywords

• Fournier’s gangrene
• mortality
• vacuum-assisted closure