Analysis of factors predisposing to increased number of complications and mortality in patients with Fournier’s gangrene

Abstract

Introduction and objective: Fournier’s gangrene is an infectious disease affecting the soft tissues of the groin area. The primary cause is bacterial infection of the tissues, which can quickly lead to necrosis and even systemic infection. Analysing the risk factors allows for estimating the potential course and complications of the disease. Materials and methods: An analysis was conducted on a group of 53 patients with Fournier’s gangrene hospitalised between 2010 and 2022 in the Military Institute of Medicine – National Research Institute, to assess the most common risk factors with a view to determining if their occurrence affects the length of hospitalisation, the severity of the disease, inflammatory parameters, kidney function, and mortality. Results: Diabetes, infection with resistant bacteria, and previous urological procedures did not significantly affect any of the examined parameters. Cardiovascular diseases, poor social status, and other cancers significantly increased the severity of the disease determined by the Fournier’s Gangrene Severity Index (FGSI). Cardiovascular diseases significantly worsened kidney function parameters. Cardiovascular and gastrointestinal diseases were the only ones significantly increasing mortality in the studied group. Hospitalisation during the COVID-19 pandemic only led to a significant increase in inflammatory parameters. No correlation was found between the number of risk factors and the length of hospitalisation, while a positive correlation was shown between the risk factors and the FGSI score. Conclusions: Patients diagnosed with Fournier’s gangrene and having cardiovascular or gastrointestinal diseases should undergo closer clinical observation to reduce mortality and the risk of complications. Patients with a higher number of risk factors present a more severe course of infection, as assessed by the FGSI.