ObjectiveTo evaluate risk factors for mortality in patients with Fournier's gangrene (FG), with emphasis in the Simplified Fournier Gangrene Severe Index Score (SFGSI).Materials and MethodsThis was a cross-sectional study that was carried out from January 2010 to December 2014, with 124 patients treated for FG in a General Hospital. Several clinical and laboratory variables, including SFGSI, were evaluated and correlated with mortality through univariate analysis and logistic regression.ResultsOf the 124 patients, 99 were men (79.8%), the mean age was 50.8±19.5 years and the main comorbidity was diabetes mellitus (51.6%). The mortality rate was 25.8%. Variables that presented independent correlation with mortality were the extension of the lesion to the abdomen (OR=4.0, CI=1.10-14.68, p=0.03), hematocrit (OR=0.81, CI=0.73-0.90, p<0.0001), potassium (OR=2.41, CI=1.13-5.10, p=0.02) and creatinine (OR=2.15, CI= 1.04-4.41, p=0.03). When hematocrit, potassium and creatinine were tested together, as part of the SFGSI, a >2 result was the largest of the independent predictors of mortality (OR=50.2; CI=13.18-191.47; p<0.0001).ConclusionThe SFGSI >2 presented a higher correlation with mortality than any variable tested alone. It seems to be a promising alternative to evaluate predictors of mortality in Fournier's gangrene. The main advantage is easy applicability because it contains only three parameters and can be used immediately after patient's admission.
Lupus cystitis is a rare and underdiagnosed urinary manifestation of LES and the presence of mild urinary symptoms and abdominal pain may alert about this possibility.
Objetivo: Analisar as características e incidência do trauma vesical durante cinco anos em um hospital geral do estado de Alagoas. Métodos: Estudo quantitativo, analítico, observacional e transversal, foram utilizados métodos de estatística descritiva para análise das variáveis. Resultados: Foram encontradas lesões vesicais em 63 pacientes, obteve-se análise dos prontuários nos anos de 2010 a 2015. Média de idade de 26,2 anos, com extremos entre 15 e 56 e desvio padrão de 9,85 (intervalo de confiança de 95%). A maioria era (76,2%) do sexo masculino. O trauma penetrante foi responsável por 65,07% dos casos, sendo em sua maioria (97,56%) decorrente de lesão por arma de fogo. O método diagnóstico foi predominantemente intraoperatório (82,53%). As lesões mais frequentes foram de cúpula vesical (23,8%), parede anterior e posterior (11,11%). O tratamento de escolha foi cirúrgico em 88,89% e conservador nos demais. A taxa de mortalidade global no trauma vesical foi de 7,93% a sobrevida média de 88,87%. Conclusão: Os dados encontrados são, em sua grande parte, condizentes com a literatura mundial para o trauma vesical, diferindo quanto a etiologia, método diagnóstico e a terapêutica adotada. Tais distinções, podem ser justificadas pelas características locais e do hospital estudado.
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