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European Journal of Trauma and Emergency Surgery
Published in: European Journal of Trauma and Emergency Surgery 4/2016

01-08-2016 | Original Article

Simple scoring system for prediction of mortality in Fournier’s gangrene

Authors: A. Erdoğan, İ. Aydoğan, K. Şenol, E. M. Üçkan, Ş. Ersöz, M. Tez

Published in: European Journal of Trauma and Emergency Surgery | Issue 4/2016

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Abstract

Purpose

To create new scoring system for prediction of hospital mortality for patients with Fournier’s gangrene(FG).

Material and method

In total, 84 patients with FG were enrolled into this study. The demographic and clinical characteristics of patients were analyzed retrospectively.

Results

The mortality rate was 11.9 %. On multivariate analyses, age >60 years, BUN >40 mg/dl, RDW >14.95 %, albumin level <20 mg/dl and presence of sepsis were significant and independent predictors of mortality. The predictive value of our score for mortality was 95.1 %.

Conclusion

Our scoring system shows adequate discriminatory function for prediction of mortality in patients with FG. Further larger scale studies can improve the performance of our score.
Literature
1.
Fournier JA. Jean-Alfred Fournier 1832-1914. Gangrene foudroyante de la verge (overwhelming gangrene). Sem Med 1883. Dis Colon Rectum. 1988;31(12):984–8.CrossRefPubMed
2.
Koukouras D, Kallidonis P, Panagopoulos C, Al-Aown A, Athanasopoulos A, Rigopoulos C, et al. Fournier’s gangrene, a urologic and surgical emergency: presentation of a multi-institutional experience with 45 cases. Urol Int. 2011;86(2):167–72.CrossRefPubMed
3.
Kilic A, Aksoy Y, Kilic L. Fournier’s gangrene: etiology, treatment, and complications. Ann Plast Surg. 2001;47(5):523–7.CrossRefPubMed
4.
Mehl AA, Nogueira Filho DC, Mantovani LM, Grippa MM, Berger R, Krauss D, et al. Management of Fournier’s gangrene: experience of a university hospital of Curitiba. Rev Col Bras Cir. 2010;37(6):435–41.CrossRefPubMed
5.
Sroczynski M, Sebastian M, Rudnicki J, Sebastian A, Agrawal AK. A complex approach to the treatment of Fournier’s gangrene. Adv Clin Exp Med Off Organ Wroc Med Univ. 2013;22(1):131–5.
6.
Laor E, Palmer LS, Tolia BM, Reid RE, Winter HI. Outcome prediction in patients with Fournier’s gangrene. J Urol. 1995;154(1):89–92.CrossRefPubMed
7.
Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med. 1985;13(10):818–29.CrossRefPubMed
8.
Yilmazlar T, Ozturk E, Ozguc H, Ercan I, Vuruskan H, Oktay B. Fournier’s gangrene: an analysis of 80 patients and a novel scoring system. Tech Coloproctol. 2010;14(3):217–23.CrossRefPubMed
9.
Lujan Marco S, Budia A, Di Capua C, Broseta E, Jimenez Cruz F. Evaluation of a severity score to predict the prognosis of Fournier’s gangrene. BJU Int. 2010;106(3):373–6.CrossRefPubMed
10.
el Benjelloun B, Souiki T, Yakla N, Ousadden A, Mazaz K, Louchi A, et al. Fournier’s gangrene: our experience with 50 patients and analysis of factors affecting mortality. World J Emerg Surg : WJES. 2013;8(1):13.CrossRefPubMedCentral
11.
Altarac S, Katusin D, Crnica S, Papes D, Rajkovic Z, Arslani N. Fournier’s gangrene: etiology and outcome analysis of 41 patients. Urol Int. 2012;88(3):289–93.CrossRefPubMed
12.
Unalp HR, Kamer E, Derici H, Atahan K, Balci U, Demirdoven C, et al. Fournier’s gangrene: evaluation of 68 patients and analysis of prognostic variables. J Postgrad Med. 2008;54(2):102–5.CrossRefPubMed
13.
Sorensen MD, Krieger JN, Rivara FP, Klein MB, Wessells H. Fournier’s gangrene: management and mortality predictors in a population based study. J Urol. 2009;182(6):2742–7.CrossRefPubMedPubMedCentral
14.
Erol B, Tuncel A, Hanci V, Tokgoz H, Yildiz A, Akduman B, et al. Fournier’s gangrene: overview of prognostic factors and definition of new prognostic parameter. Urology. 2010;75(5):1193–8.CrossRefPubMed
15.
16.
Wong CH, Khin LW, Heng KS, Tan KC, Low CO. The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections. Crit Care Med. 2004;32(7):1535–41.CrossRefPubMed
17.
Gawande AA, Kwaan MR, Regenbogen SE, Lipsitz SA, Zinner MJ. An Apgar score for surgery. J Am Coll Surg. 2007;204(2):201–8.CrossRefPubMed
18.
Ersay A, Yilmaz G, Akgun Y, Celik Y. Factors affecting mortality of Fournier’s gangrene: review of 70 patients. ANZ J Surg. 2007;77(1–2):43–8.CrossRefPubMed
19.
Hejase MJ, Simonin JE, Bihrle R, Coogan CL. Genital Fournier’s gangrene: experience with 38 patients. Urology. 1996;47(5):734–9.CrossRefPubMed
20.
Katib A, Al-Adawi M, Dakkak B, Bakhsh A. A three-year review of the management of Fournier’s gangrene presented in a single Saudi Arabian institute. Cent European J Urol. 2013;66(3):331–4.PubMedPubMedCentral
21.
Tuncel A, Keten T, Aslan Y, Kayali M, Erkan A, Koseoglu E, et al. Comparison of different scoring systems for outcome prediction in patients with Fournier’s gangrene: experience with 50 patients. Scand J Urol. 2014;48:393–9.CrossRefPubMed
22.
Sallami S, Maalla R, Gammoudi A, Ben Jdidia G, Tarhouni L, Horchani A. Fournier’s gangrene: what are the prognostic factors? Our experience with 40 patients. La Tunis Med. 2012;90(10):708–14.PubMed
23.
Yeniyol CO, Suelozgen T, Arslan M, Ayder AR. Fournier’s gangrene: experience with 25 patients and use of Fournier’s gangrene severity index score. Urology. 2004;64(2):218–22.CrossRefPubMed
24.
Corcoran AT, Smaldone MC, Gibbons EP, Walsh TJ, Davies BJ. Validation of the Fournier’s gangrene severity index in a large contemporary series. J Urol. 2008;180(3):944–8.CrossRefPubMed
25.
Czymek R, Kujath P, Bruch HP, Pfeiffer D, Nebrig M, Seehofer D, et al. Treatment, outcome and quality of life after Fournier’s gangrene: a multicentre study. Colorectal Dis Off J Assoc Coloproctol Gt Br Irel. 2013;15(12):1529–36.
26.
Yanar H, Taviloglu K, Ertekin C, Guloglu R, Zorba U, Cabioglu N, et al. Fournier’s gangrene: risk factors and strategies for management. World J Surg. 2006;30(9):1750–4.CrossRefPubMed
27.
Sugihara T, Yasunaga H, Horiguchi H, Fujimura T, Ohe K, Matsuda S, et al. Impact of surgical intervention timing on the case fatality rate for Fournier’s gangrene: an analysis of 379 cases. BJU Int. 2012;110(11 Pt C):E1096–100.CrossRefPubMed
28.
29.
García Marín A, Turégano Fuentes F, Cuadrado Ayuso M, Andueza Lillo JA, Cano Ballesteros JC, Pérez López M. Predictive factors for mortality in Fournier’s gangrene: a series of 59 cases. Cir Esp. 2015;93(1):12–7.CrossRefPubMed
30.
Ruiz-Tovar J, Cordoba L, Devesa JM. Prognostic factors in Fournier gangrene. Asian J Asian Surg Assoc. 2012;35(1):37–41.CrossRef
31.
Clayton MD, Fowler JE Jr, Sharifi R, Pearl RK. Causes, presentation and survival of fifty-seven patients with necrotizing fasciitis of the male genitalia. Surg Gynecol Obstet. 1990;170(1):49–55.PubMed
32.
Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med. 2009;133(4):628–32.PubMed
33.
Bazick HS, Chang D, Mahadevappa K, Gibbons FK, Christopher KB. Red cell distribution width and all-cause mortality in critically ill patients. Crit Care Med. 2011;39(8):1913–21.CrossRefPubMedPubMedCentral
34.
Sadaka F, O’Brien J, Prakash S. Red cell distribution width and outcome in patients with septic shock. J Intensiv Care Med. 2013;28(5):307–13.CrossRef
35.
Kim CH, Park JT, Kim EJ, Han JH, Han JS, Choi JY, et al. An increase in red blood cell distribution width from baseline predicts mortality in patients with severe sepsis or septic shock. Crit Care (London, England). 2013;17(6):R282.CrossRef
36.
Senol K, Saylam B, Kocaay F, Tez M. Red cell distribution width as a predictor of mortality in acute pancreatitis. Am J Emerg Med. 2013;31(4):687–9.CrossRefPubMed
Metadata
Title
Simple scoring system for prediction of mortality in Fournier’s gangrene
Authors
A. Erdoğan
İ. Aydoğan
K. Şenol
E. M. Üçkan
Ş. Ersöz
M. Tez
Publication date
01-08-2016
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery / Issue 4/2016
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-015-0572-2

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