Efficacy of Non-invasive Serum Markers in Predicting the Prognosis of Fournier Gangrene

Abstract

Objective: Fournier gangrene is a true urological emergency. This study aimed to evaluate the efficacy of biochemical diagnostic markers in predicting the prognosis of patients who presented to the hospital with Fournier gangrene. Materials and Methods: Sixty-eight male patients who underwent aggressive debridement and drainage for Fournier gangrene were included in the study. The patients were divided into two groups: Group 1 comprised patients who died and group 2 comprised those who survived. Fournier Gangrene Severity index (FGSI), Uludağ FGSI (UFGSI), and age-adjusted Charlson Comorbidity index (ACCI) scores, and urea, creatinine, sodium, potassium, hemogram, aspartat aminotransferaz (AST)/alanin aminotransferaz (ALT), total protein, albumin, globulin, alkaline phosphatase and lactate dehydrogenase values of all patients were recorded. The AST/ALT, albumin/globulin, neutrophil/lymphocyte, and platelet/lymphocyte ratios (PLR) were also noted. Results: The mean age of all patients was 59.04±13.99 (25-89) years. The FGSI, UFGSI, and ACCI scores of the patients in group 1 were found to be significantly worse than those in group 2. When we evaluated systemic inflammation parameters, there was a statistically significant difference between the groups in terms of the AST/ALT and neutrophil/lymphocyte ratios (NLRs) (p=0.042 and 0.023, respectively), but no significant difference was found in relation to the albumin/globulin and PLRs. Conclusion: Non-invasive serum markers, such as AST/ALT and NLR, appear to be useful in evaluating the prognosis of patients with Fournier gangrene. Therefore, we recommend the use of these ratios in the initial evaluation of this patient group.

Keywords

• fournier gangrene
• serum markers
• prognosis
• mortality