Risk factors for mortality in fournier's gangrene in a general hospital: use of simplified founier gangrene severe index score (SFGSI)

Abstract

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.

Incorporating Simplified Fournier's Gangrene Severity Index with early surgical intervention can maximize survival in high‐risk Fournier's gangrene patients

“…Tenorio et al also verified SFGSI as a promising alternative to predict outcome, and a SFGSI score >2 points is highly correlated to mortality in their series of FG patients. 26 Accordingly, we stratified FG patients into different risk groups using the SFGSI for further analysis. The low-risk group included FG patients with SFGSI ≤2 points, and FG patients with SFGSI >2 points were categorized into the high-risk group.…”

“…Compared with sophisticated FGSI, SFGSI is a user‐friendly scoring system containing just three elements: serum creatinine, serum potassium and hematocrit. SFGSI can be regarded as the simple version of FGSI, and has been proved with non‐inferior predictive values to FGSI . The details of the SFGSI calculating profile is shown in .…”

“…SFGSI can be regarded as the simple version of FGSI, and has been proved with non-inferior predictive values to FGSI. 20,26 The details of the SFGSI calculating profile is shown in Table S2. The normal value of each parameter is set as "0" point, and the deviation from normal value is scored +1 to +4 points.…”

Re: Simplified Fournier's gangrene severe index score (SFGSI)

“…We read the publication on “Risk factors for mortality in Fournier's gangrene in a general hospital: use of simplified Fournier's gangrene severe index score (SFGSI)” with great interest ( 1 ). Tenório et al concluded that “The main advantage is easy applicability because it contains only three parameters and can be used immediately after patient's admission” ( 1 ). Indeed, as noted by Yeniyol et al, “Patients’ metabolic status and the extent of disease at presentation is an important factor in the prognosis of Fournier's gangrene” ( 2 ).…”

A rare case of colonic perforation presenting as Fournier’s gangrene

“…4 Despite the various advancements in management, the mortality rate is very high at 20-40%. 5 Although few cases of FG developing through local spread of infection after rectum and sigmoid perforation have been reported in literature, to the best of our knowledge there has been only 1 case of FG developing from intestinal perforation with an inguinal hernia. [6][7][8][9] In this article we describe a case of colonic perforation peritonitis presenting with FG.…”