MP25-08 EVALUATION OF THE UTILITY OF DIFFERENT SCORING SYSTEMS (FGSI, LRINEC AND NLR) IN THE MANAGEMENT OF FOURNIER'S GANGRENE

Abstract

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Prostate & Genitalia1 Apr 2015MP25-08 EVALUATION OF THE UTILITY OF DIFFERENT SCORING SYSTEMS (FGSI, LRINEC AND NLR) IN THE MANAGEMENT OF FOURNIER'S GANGRENE Ozan Bozkurt, Volkan Sen, Omer Demir, and Adil Esen Ozan BozkurtOzan Bozkurt More articles by this author , Volkan SenVolkan Sen More articles by this author , Omer DemirOmer Demir More articles by this author , and Adil EsenAdil Esen More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1211AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Fournier's gangrene is still a lethal disease despite recent developments in the area of medicine. Aim of this study is to evaluate the mortality and morbidity prediction capability of three different scoring systems; Fournier's Gangrene Severity Index (FGSI), Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) and neutrophile-lymphocyte ratio (NLR). METHODS Medical records of all patients treated for FG with the final histopathological diagnosis between October 2008 and January 2013 were retrospectively evaluated. Data were collected from medical history; physical examination findings; biochemical and microbiological tests and tissue cultures. FGSI and LRINEC scores and NLR were determined for all patients. Then, it was explored whether higher FGSI (<4 vs ≥4), LRINEC (<6 vs ≥6) or NLR (<10 vs ≥10) were associated with worse prognosis. RESULTS A total of 33 patients were evaluated; 3 died ( 9.1% ) and 30 ( 90.9% ) survived. Mean age was 57.6±13.2 years. Survivors were younger than nonsurvivors ( 56±12.8 vs. 72.9±7.3, p<0.05). Diabetes mellitus was the most encountered predisposing factor with 66.7% prevalence. All patients with localized disease (100%) and 8/11 patients (72.7%) with extended disease survived (p<0.05). Patients with higher FGSI scores, LRINEC scores and NLR were more likely to require mechanical ventilation in intensive care unit, longer hospitalization times and were more likely to die compared to patients with lower scores (Table 1). CONCLUSIONS In conclusion, all evaluated scoring systems;FGSI, LRINEC and NLR; are capable of pointing out worse prognosis including mechanical ventilation requirement and mortality. NLR has the advantage of its rapid, simple and low-cost characteristics. Table 1. Comparison of patients according to FGSI score, LRINEC score and NLR at admission.(Auxillary procedures : Requirement of cystostomy and/or diverting colostomy and/or orchiectomy during initial debridement. BMI-Body mass index, DM-Diabetes mellitus, ICU-Intensive care unit.°p< 0.05 was deemed statistically significant.) FGSI< 4 (n=23) FGSI≥4 (n=10) LRINEC< 6 (n=19) LRINEC≥6 (n=14) NLR< 10 (n=21) NLR≥10 (n=12) Age (years) 56.4±13 60.3±14.2 56.4±14.1 59.2±12.4 56.5±11.6 59.4±16.3 BMI (kg/m2) 29.7±5.8 26.9±4.2 28.8±5.1 28.8±6.1 29.6±6.1 27.5±3.9 DM (%) 69.6 60 68.4 64.3 66.7 66.7 Smoking (%) 60.9 60 63.2 57.1 57.1 66.7 Extended disease (%) 26.1 50 26.3 42.9 19 58.3 Auxillary procedures (%) 34.8 50 26.3 57.1 28.6 58.3 ICU requirement (%) 13 40° 5.3 42.9° 9.5 41.7° Greft requirement (%) 26.1 50 15.8 57.1 23.8 50 Reconstruction time (days) 22.1±24.5 26.6±21.5 17.9±22.3 31.3±23.6 20±23.6 31±22.3 Hospitalization time (days) 22±19.1 30.7±23.6 18.7±15.9 32.6±23.9 19.9±18.2 32.9±22.6° Mortality (%) 4.3 20° 5.3 14.3° 0 25° © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e287-e288 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ozan Bozkurt More articles by this author Volkan Sen More articles by this author Omer Demir More articles by this author Adil Esen More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...