Comparison of different scoring systems for outcome prediction in patients with Fournier's gangrene: Experience with 50 patients

Tuncel, Altuğ; Keten, Tanju; Aslan, Yılmaz; Kayalı, Mustafa; Erkan, Anil; Köseoğlu, Ersin; Atan, Ali

doi:10.3109/21681805.2014.886289

Cited by 25 publications

(42 citation statements)

References 17 publications

(55 reference statements)

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“…This result was also confirmed by the same author's recent study. [14] In the present study, the median FGSI score was 2 (0-9) for survivors and 6 (2-14) for those who died with a significant difference between groups.…”

Section: Discussionsupporting

confidence: 40%

“…[2,3,10,13] Some previous studies showed a younger age in survivors, although some others did not find any difference at the age of disease onset between survivors and non-survivors. [2,4,10,11,14] In our study group, there were 36 (92.3%) males, and the survivor group consisted of significantly younger patients (p=0.047). Cox regression analysis found advanced age as an independent prognostic risk factor in our study (p=0.016, 95% CI 1.017-1.176).…”

Section: Discussionmentioning

confidence: 64%

“…[2,4] Three separate studies found significantly higher incidence of the disease in body in the non-survivors. [8,10,11,14] Corcoran et al [7] found that although total body surface area (TBSA) involved was suggestive of a poor prognosis among all operative characteristics investigated, only lower extremity or abdominal wall involvement was associated with inpatient mortality. In our study, the involved surface area was similar in survivor and non-survivor groups.…”

Section: Discussionmentioning

confidence: 99%

“…These include low hematocrit, and serum albumin levels, high blood urea nitrogen, creatinine and high alkaline phosphatase levels. [2,10,11,14,24] In addition, Corcoran et al [7] found that specific metabolic parameters such as serum creatinine, bicarbonate, lactate, and calcium were important prognostic factors. Similarly, high blood urea nitrogen, low serum albumin, and hematocrit levels were associated with inpatient mortality in our series.…”

Section: Discussionmentioning

confidence: 99%

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Overview of different scoring systems in Fournier’s Gangrene and assessment of prognostic factors

Doluoğlu

Karagöz

Kılınç

et al. 2016

Turkish Journal of Urology

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Objective: In this study we aimed to evaluate prognostic factors for the survival of patients with Fournier's gangrene (FG), and overview different validated scoring systems for outcome prediction. Material and methods:We retrospectively analyzed the data of 39 patients treated for FG in our clinic. Data were collected on medical history, symptoms, physical examination findings, vital signs, laboratory parameters at admission and at the end of treatment, timing and extent of surgical debridement, and the antibiotic treatment used. The Fournier's Gangrene Severity Index (FGSI) and Charlson Comorbidity Index (CCI) were used to predict outcome. The data were analyzed in relation with the survival of the patients. Mann-Whitney U test, chi -square test, Wilcoxon signed rank test, and Cox regression analysis were used for the statistical analysis.Results: Of 39 patients analyzed, 8 (20.5%) died and 31 (79.5%) survived. The median FGSI score on admission was 2 (0-9) for the survivors and 6 (2-14) for the non-survivors (p=0.004). The median CCI scores of the survivors and non-survivors were 2 (0-10) and 6.5 (5-11), respectively (p=0.001). Except for urea, albumin and hematocrit levels, no significant differences were found between survivors and non-survivors for other laboratory parameters on admission. Lower albumin levels and advanced age were found to be associated with mortality. Conclusion:High blood urea, low albumin, and low hematocrit levels were associated with poor prognosis. High CCI and FGSI scores could be associated with a poor prognosis in patients with FG.

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Section: Discussionsupporting

confidence: 40%

Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Overview of different scoring systems in Fournier’s Gangrene and assessment of prognostic factors

Doluoğlu

Karagöz

Kılınç

et al. 2016

Turkish Journal of Urology

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“…Delay in surgical debridement can increase the extent of the necrosis, and lead to a worse prognosis. 21,22 Early admission, rapid diagnosis, and adequate surgical treatment are crucial components in achieving a successful outcome. The median duration of symptoms before admission was a day longer in non-survivors (4 vs. 3), but this was not predictive for mortality in our study.…”

Section: Prognostic Factors Affecting Mortality In Fournier's Gangrenementioning

confidence: 99%

Analysis of prognostic factors affecting mortality in Fournier’s gangrene: A study of 72 cases

Tarchouli

Bourazza²,

Essarghini³

et al. 2015

CUAJ

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Introduction: Fournier's gangrene is a rapidly progressing necrotizing fasciitis of the perineum and genital area associated with a high mortality rate. We presented our experience in managing this entity and identified prognostic factors affecting mortality. Methods: We carried out a retrospective study of 72 patients treated for Fournier's gangrene at our institution between January 2005 and December 2014. Patients were divided into survivors and nonsurvivors and potential prognostic factors were analyzed. Results: Of the 72 patients, 64 were males (89%) and 8 females (11%), with a mean age of 51 years. The most common predisposing factor was diabetes mellitus (38%). The mortality rate was 17% (12 patients died). Statistically significant differences were not found in age, gender, and predisposing factors, except in heart disease (p = 0.038). Individual laboratory parameters significantly correlating with mortality included hemoglobin (p = 0.023), hematocrit (p = 0.019), serum urea (p = 0.009), creatinine (p = 0.042), and potassium (p = 0.026). Severe sepsis on admission and the extent of affected surface area also predicted higher mortality. Others factors, such as duration of symptoms before admission, number of surgical debridement, diverting colostomy and length of hospital stay, did not show significant differences. The median Fournier's Gangrene Severity Index (FGSI) was significantly higher in non-survivors (p = 0.002). Conclusion: Fournier's gangrene is a severe surgical emergency requiring early diagnosis and aggressive therapy. Identification of prognostic factors is essential to establish an optimal treatment and to improve outcome. The FGSI is a simple and valid method for predicting disease severity and patient survival.

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Urea

Wang

Ran

Jiang

2014

Subcellular Biochemistry

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Urea is generated by the urea cycle enzymes, which are mainly in the liver but are also ubiquitously expressed at low levels in other tissues. The metabolic process is altered in several conditions such as by diets, hormones, and diseases. Urea is then eliminated through fluids, especially urine. Blood urea nitrogen (BUN) has been utilized to evaluate renal function for decades. New roles for urea in the urinary system, circulation system, respiratory system, digestive system, nervous system, etc., were reported lately, which suggests clinical significance of urea.

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Comparison of different scoring systems for outcome prediction in patients with Fournier's gangrene: Experience with 50 patients

Abstract: Only the UFGSI score could predict the disease severity and the patients' survival. The findings did not support previous findings that an UFGSI threshold of 9 is a predictor of mortality during initial evaluation.

Cited by 25 publications

References 17 publications

Overview of different scoring systems in Fournier’s Gangrene and assessment of prognostic factors

Overview of different scoring systems in Fournier’s Gangrene and assessment of prognostic factors

Analysis of prognostic factors affecting mortality in Fournier’s gangrene: A study of 72 cases

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