Are neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as effective as Fournier's gangrene severity index for predicting the number of debridements in Fourner's gangrene?

Kahramanca, Şahin; Kaya, İsmail; Özgehan, Gülay; İrem, Burak; Dural, Ibrahim; Küçükpınar, Tevfik; Kargıcı, Hülagü

doi:10.5505/tjtes.2014.62829

Cited by 26 publications

(23 citation statements)

References 20 publications

(41 reference statements)

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“…Therefore, several studies have focused on reducing the number of parameters in order to facilitate mortality prediction in FG. 12,13 One such parameter for predicting mortality in FG was assessed by Kahramanca et al 3 , who found that the neutrophil-lymphocyte ratio and platelet-to-lymphocyte ratio were useful for determining FG prognosis. 3 As early and aggressive surgical therapy remains the most effective treatment, we focused on the number of surgical debridements.…”

Section: Discussionmentioning

confidence: 99%

“…Many scoring systems have been proposed for predicting the mortality rate of FG patients, including important indexes such as APACHE II, FGSI, the Laboratory Risk Indicator for Necrotizing Fasciitis and UFGSI. 1,3,5 However, under urgent conditions, it is not always easy to calculate multiple parameters. Therefore, several studies have focused on reducing the number of parameters in order to facilitate mortality prediction in FG.…”

Section: Discussionmentioning

confidence: 99%

“…The leukocyte count and monocyte count percentages were measured by an automated hematology analyzer (Coulter Counter Model S-Plus Jr, Coulter Electronics, Hialeah, FL). The reference interval of monocyte and of lymphocyte were 300-900 per mm 3 and 900-3.700 per mm 3 respectively.…”

Section: Methodsmentioning

confidence: 99%

“…1 The principal therapeutic approaches for FG are aggressive surgical debridements, with the administration of wide-spectrum antibiotics and supportive drugs. 3 Nevertheless, FG continues to have a high mortality rate. Despite being a well-described entity, the disease has a mortality rate ranging from 20% to 50%.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 Although first described by French physician H. Baurienne in 1764, the disease was named after French venereologist Jean Alfred Fournier, who presented in 1883 the case of a young male with perineal gangrene of sudden onset. 3 FG affects mainly males (the male/female rate is 10:1) and patients over 50 years of age. 1 The principal therapeutic approaches for FG are aggressive surgical debridements, with the administration of wide-spectrum antibiotics and supportive drugs.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Value of the Monocyte-to-Lymphocyte Ratio for Determining Number of Debridements in Treatment of Fournier’s Gangrene

Anuk¹,

Yıldırım²,

Güzel³

et al. 2017

TJCD

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Amaç: Fournier gangreni (FG) anorektal bölgenin klinik olarak çok hızlı kötüleşen, ölümcül nekrotizan fasiitidir. FG tedavisinin temelini agresif cerrahi debridman oluşturur. Güncel skorlama sistemleri FG'de mortalite üzerine yoğunlaşmıştır. Bununla birlikte serum belirteçleri yararlı olabilir. Bu çalışmada FG hastalarındaki debridman sayısını belirlemede monosit-lenfosit oranının (MLO) klinik etkisini ortaya koymayı amaçladık. Yöntem: 2010-2016 yılları arasında hastanelerimiz acil servisinde FG tanısıyla tanı konup opere edilen 59 hasta çalışmaya dahil edildi. Tek debridman uygulanan grup 1 ve birden çok debridman uygulanan hastalar grup 2 olarak iki gruba ayrıldılar. Grupların ortalama yaş, cinsiyet, semptom süresi, predispozan faktör, yara kültür pozitifliği, kolostomi durumu, yatış anındaki MLO'lar, tedavi protokolleri, mortalite oranları karşılaştırıldı. Bulgular: İki grup arasında yara kültür sonuçları ve kolostomi durumları arasında istatistiksel anlamlı fark bulundu (p=0,001 ve p=0,008). Mortalite oranları arasında anlamlı fark bulunamadı (p=0,749). Predispozan faktörler ve semptomların süresi arasında gruplar arası anlamlı fark bulunamadı (p=0,069, p=0,091). Grup 2'de MLO anlamlı oranda yüksekti (p<0,001). 0,549 cut-off değerinde MLO debridman sayını öngörmede %79,4 sensitivite ve %76 oranında spesifiteye sahipti. Ayrıca MLO debridman sayısını diğer faktörlerden bağımsız olarak öngörebilmekteydi (p<0,001). Sonuç: MLO değeri birden çok debridman yapılan hastalarda anlamlı oranda yüksek bulundu. Bu sonuç, MLO'nun tek bir parametre olarak FG ciddiyetini göstermesi bakımından önemlidir. Gelecekte düzenlenebilecek daha yüksek hasta popülasyonlu çalışmalar parametrenin gücünü gösterebilmeleri açısından önem kazanmıştır. Anahtar Kelimeler: Fournier gangreni, debridman, monosit, lenfosit ÖZ ABSTRACTAim: Fournier's gangrene (FG) is a rapidly progressive, fulminant necrotizing fasciitis of the anogenital region. Treatment of FG consists of aggressive surgical debridements. The current scoring systems in FG focus on mortality. However, simple biomarkers could be useful. Here we aim to investigate the clinical usefulness of monocyte-to-lymphocyte ratio (MLR) in determining the number of debridements in FG patients. Method: Fifty-nine patients were diagnosed with FG and operated in the emergency unit between 2010 and 2016. The patients were separated into a single-debridement group and a multiple-debridement group. The groups were compared in terms of mean age, gender, duration of symptoms, predisposing factors, wound culture positivity, MLR values at admission, treatment protocols, and mortality rates. Results: The two groups differed significantly in wound culture results and colostomy status (p=0.001 and p=0.008). There was no significant difference in mortality rate (p=0.749). Furthermore, there were no significant differences between the groups in terms of predisposing factors or duration of symptoms (p=0.069 and p=0.091). The multiple-debridement group had a significantly higher MLR value (p<0.001). MLR under ...

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