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Scoring Systems for the Prediction of Mortality in Patient with Fournier’s Gangrene: an Analysis of 60 Patients

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Abstract

The aim of this study was to evaluate demographic and clinical findings in Fournier’s gangrene and to assess feasibility of several scoring indexes for predicting morbidity and mortality. Patients who underwent surgery for Fournier’s gangrene between 2006 and 2020 were analyzed. Scores of Fournier Gangrene Severity Index, Uludag Fournier Gangrene Severity Index, Age-adjusted Charlson Comorbidity Index, and Sequential Organ Failure System for each patient were calculated. Mortality rate was regarded as the primary outcome. There were 60 patients with a mean age of 61.4 SD 16.0 years. There were 10 deaths with a mortality rate of 16.7%. There were significant differences between non-survivor (n = 10) and survivor patients (n = 50) with regard to hemoglobin, serum total protein, and serum bicarbonate levels (p < 0.05). In all patients who survived, the scores of all indexes were significantly higher than that of the patients who were non-survivors (p < 0.05). Although the diagnostic accuracy of Fournier Gangrene Severity Index and Uludag Fournier Gangrene Severity Index for mortality was moderate, diagnostic accuracies of Age-adjusted Charlson Comorbidity Index and Sequential Organ Failure System score for prediction of mortality were regarded as good. Fournier Gangrene Severity Index, Uludag Fournier Gangrene Severity Index, Age-adjusted Charlson Comorbidity Index, and Sequential Organ Failure System score were shown to be associated with mortality in Fournier’s gangrene. Diagnostic accuracies of Uludag Fournier Gangrene Severity Index, Age-adjusted Charlson Comorbidity Index, and Sequential Organ Failure System score for prediction of mortality were higher than that of Fournier Gangrene Severity Index.

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Authors and Affiliations

  1. Department of General Surgery, Farabi Hospital, Karadeniz Technical University, Trabzon, Turkey

    Mehmet Arif Usta, Serkan Tayar, Arif Burak Cekic, Ali Guner & Serdar Turkyilmaz

  2. General Surgery Clinic, İdil State Hospital, Sirnak, Turkey

    Mehmet Ulusahin

  3. Department of Urology, Farabi Hospital, Karadeniz Technical University, Trabzon, Turkey

    Ilke Onur Kazaz

Authors
  1. Mehmet Arif Usta
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  2. Mehmet Ulusahin
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  3. Serkan Tayar
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  4. Arif Burak Cekic
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  5. Ilke Onur Kazaz
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  6. Ali Guner
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  7. Serdar Turkyilmaz
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Correspondence to Mehmet Arif Usta.

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Approval was taken from the hospital ethical committee. It was performed in accordance with the Helsinki Declaration on human studies. Written consent could not be taken from the patients due to the retrospective design of the study.

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The authors declare that they have no conflict of interest.

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Usta, M.A., Ulusahin, M., Tayar, S. et al. Scoring Systems for the Prediction of Mortality in Patient with Fournier’s Gangrene: an Analysis of 60 Patients. Indian J Surg 83, 696–702 (2021). https://doi.org/10.1007/s12262-020-02421-6

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  • DOI: https://doi.org/10.1007/s12262-020-02421-6

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