Risk factors of Fournier’s gangrene associated with mortality in Sunpasittiprasong Hospital

Abstract

Objective: To determine the mortality rate in patients with Fournier’s gangrene (FG) in Sunpasittiprasong Hospital and to identify potential risk factors associated with mortality among patients of FG. Materials and Methods: This retrospective cohort study investigated patients diagnosed with FG in Sunpasittiprasong Hospital from 2016 to 2021. Data related to clinical presentation, demographics, comorbidities, etiology, laboratory investigation, and therapeutic intervention of the patients were recorded. Prognostic severity indexes were calculated. All factors were statistically analyzed using univariate and then multivariate analysis. Results: Of 62 patients, the mortality rate was 29% (18 of 62). The significant risk factors for death included patients with kidney disease, septic shock, respiratory failure, acute kidney injury, low mean arterial blood pressure (MAP), admission to ICU and prolonged ventilator used. Risk factors from the laboratory data included abnormal coagulogram, high serum creatinine, lactate, and low bicarbonate. Some prognostic scoring systems were able to predict prognosis and mortality. Multivariate analysis revealed that patients with kidney disease (p = 0.007) or respiratory failure at presentation (p = 0.020) were significantly associated with mortality. Conclusions: The significant risk factors associated with mortality among patients with FG were kidney disease or respiratory failure. Some prognostic scoring systems may be applied to Thai patients with FG to predict prognosis.