Comparison between Fournier's Gangrene and Scrotal Abscess Using Fournier's Gangrene Severity Index

Abstract

Purpose: To evaluate effective factors in the survival of patients with Fournier’s gangrene (FG) and scrotal abscess, and to determine the validity of the Fournier’s gangrene severity index (FGSI), which was designed for determining disease severity in these patients. Materials and Methods: Twenty-eight men who treated for FG were enrolled. The data were evaluated about medical history, extent of body surface area involved (%), and the FGSI, which index presents patients’ vital signs (body temperature, heart and respiratory rates) and metabolic parameters (serum sodium, potassium, creatinine, bicarbonate, hematocrit, and white blood cell count). All the patients had antibiotic treatment and radical surgical debridement. The data were assessed according to whether the patient of FG survived or died, and also compared in patients with scrotal abscess (n=26). Results: Of the evaluated 28 FG patients, 6 died (21.4%). The difference in median age between survivors (57.5 years) and those who died (69.0 years) was not significant (p=0.18). Escherichia coli is the most common pathogen in 25% of FG and 15% of scrotal abscess patients. The median extent of the body surface area involved in patients who survived and died was 2.5% and 3.5%, respectively (p =0.13). However, the median FGSI scores for nonsurvivors and survivors of FG, and patients of scrotal abscess were 10.0±3.6, 3.3±2.6, and 0.9±2.6, respectively (p<0.01). The heart rate and serum creatinine level at the admission were significant prognostic parameters in patients with FG. Conclusions: The FGSI score appeared to be predicts the disease severity and the patient's survival in patients with FG and scrotal abscess.