Comparison of Mortality in Fournier's Gangrene with the Two Scoring Systems.

Abstract

To determine the factors associated with mortality in Fournier's gangrene (FG) toward informing the development of effective treatment strategies. A descriptive study. Department of Surgery, University of Health Sciences, Okmeydani Education and Research Hospital, Istanbul, Turkey, from February 2012 to September 2017. Informations of 30 patients treated for FG were examined retrospectively. The deceased patients (Group 1, n = 8) were analysed separately from the living ones (Group 2, n = 22). Informations in this analysis contained gender, age score, dissemination score, Uludag Fournier's Gangrene Severity Index (UFGSI) and Fournier's Gangrene Severity Index (FGSI) scores, serum levels of urea, infection source, the presence of diabetes, obesity, and other comorbidities, the presence of stoma for diversion, duration of the vacuum-assisted closure treatment, hospitalisation time, intensive care period, and species of bacteria isolated. The overall mortality rate was detected as 26%. A significant difference between the two groups concerning age score of UFGSI parameters was found. The dissemination score of the infection, which is one of the UFGSI parameters, was significantly higher in Group 1 than in Group 2. According to UFGSI and FGSI scores, the scores of group 1 patients were significantly higher. To determine the incidence of mortality, the UFGSI and FGSI had 87.5% sensitivity and had 96% and 91% specificity, respectively. The cut-off values for UFGSI and FGSI were 10 and seven, respectively. Based on the findings described in this study, age and dissemination scores from the UFGSI can be used to predict patient outcome. Patients with a UFGSI score greater than 10 have a higher mortality rate.