Is hemoglobin A1c level effective in predicting the prognosis of Fournier gangrene?

Abstract

Objectives:To evaluate the effect of immune failure and/or diabetes mellitus (DM) association on the mortality and morbidity of the Fournier's Gangrene (FG), and interrelatedly, the usability of HbA1c level in the prediction of prognosis.Materials and Methods:The data of 38 patients with the diagnosis of FG were investigated retrospectively. The patients were divided into two groups as patients with DM (Group 1, n = 18) and non-diabetics (Group 2, n = 20). The patients in group 1 were also divided into two subgroups as patients with HbA1c value ≥7 (Group 1a) and HbA1c value <7 (Group 1b).Results:The mean age of all 38 male patients was 66.3 ± 6.4 years. The initial symptoms were scrotal rash and swelling (n = 20, 52.6%), high fever (>38°C) (n = 22, 57.8%), purulent discharge from genital or perineal areas (n = 13, 34.2%), skin bruises (n = 11, 28.9%) and general state disorder in five patients that were admitted from day care center (13.1%). DM, as the most often comorbid disease, was detected in 18 patients (47.3%). Six patients (15.7%) were deceased during the follow-up period.Conclusion:In the present study, the researchers determined that diabetic patients with HbA1c level of 7 or higher had worse prognosis, and increased mortality.

Comparison Between Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio As Predictors of Mortality on Fournier's Gangrene Cases

“…To address this, we included HbA1c levels as a laboratory test to predict diabetes-associated complications in DM patients. [ 24 ] Our findings indicate that high HbA1c levels (≥6.5) were significantly associated with mortality, in line with previous studies. [ 24 ] Elevated and uncontrolled blood glucose levels, as indicated by HbA1c, may lead to vascular disease and suppressed immunity, ultimately increasing susceptibility to mortality.…”

Fournier’s Gangrene: Literature Review and Clinical Cases

“…Sen et al [14] indicate the need to determine glycated hemoglobin in order to predict the outcome of the disease, since patients with a high level of this indicator in the study had a significantly more often adverse outcome.…”

Are there factors in the disease of peroneal necrotizing fasciitis which should be used when choosing the anesthetic technique?: Descriptive analysis of a cohort from 2 centers

“…[ 12 ] In some studies, some diseases that cause an immune system failure (such as DM) have been reported to increase susceptibility to FG. [ 13 – 15 ] In the current study, 55.7% of the patients had one or more comorbid diseases. When evaluated concerning comorbidities, the most significant was seen to be DM in 43.4% of the current study patients, followed by other pathologies, namely chronic renal failure (CRF) and cardiac diseases.…”