Der Urologe

, Volume 52, Issue 10, pp 1422–1429

Vorhersage der Erkrankungsschwere von Patienten mit Fournier-Gangrän

  • F. Roghmann
  • C, von Bodman
  • Z. Tian
  • M. Brock
  • B. Löppenberg
  • K. Braun
  • A. Hinkel
  • J. Palisaar
  • J. Noldus
Leitthema

Zusammenfassung

Das Fournier-Gangrän (FG) ist eine seltene, lebensbedrohliche Erkrankung. Zwei etablierte, komplexe Indices zur Prognosevorhersage [Fournier’s Gangrene Severity Index (FGSI) und Uludag FGSI (UFGSI)] wurden anhand unseres Kollektivs validiert. Anschließend entwickelten wir ein Nomogramm basierend auf einfachen klinischen Parametern zur Vorhersage der 30-Tage-Mortalität.

In die Studie wurden 44 Patienten mit FG eingeschlossen. Die Indices wurden ermittelt. Eine statistische Analyse mittels Mann-Whitney-U- und χ2-Test wurde durchgeführt. Das Nomogramm wurde berechnet und anschließend mittels ROC- („receiver operating characteristic“-)Kurvenanalyse die Vorhersagegenauigkeit bestimmt. Die 30-Tage-Mortalität lag bei 30 %. Hohe FGSI- (Median 6 vs. 2; p = 0,002) und UFGSI-Werte (Median 7 vs. 3; p = 0,002) waren mit der 30-Tage-Mortalität assoziiert. Unser Nomogramm, basierend auf Atem- und Herzfrequenz, erreichte für die 30-Tage-Mortalität eine Vorhersagegenauigkeit von 82,4 %. FGSI, UFGSI und FG-Nomogramm sind zur Vorhersage des Erkrankungsverlaufs anwendbar. Das FG-Nomogramm könnte aufgrund der einfachen Berechnung die Anwendung im klinischen Alltag erleichtern.

Schlüsselwörter

„Fournier’s Gangrene Severity Index“ Outcome Mortalität Vorhersagegenauigkeit Nomogramm 

Outcome prediction in patients with Fournier’s gangrene

Abstract

Fournier’s gangrene (FG) is a rare but life-threatening disease. There have been efforts to develop reliable tools for outcome prediction in FG patients, such as the Fournier’s gangrene severity index (FGSI) and Uludag FGSI (UFGSI). In this study the FGSI and UFGSI were validated in a patient cohort and a nomogram for prediction of 30-day mortality was developed.

A total of 44 patients with FG were included in the study. The two index scores were applied and statistical analyses were performed. The nomogram was calculated and the predictive accuracy was estimated using ROC curve analysis. The 30-day mortality rate was 30 %. High FGSI (median 6 versus 2; P = 0.002) and UFGSI (median 7 versus 3; P = 0.002) values were associated with 30-day mortality. The nomogram for the prediction of 30-day mortality (based on heart and respiratory rate) had an estimated predictive accuracy of 82.4 %. FGSI, UFGSI and FG nomogram are useful for outcome prediction in FG patients. The FG nomogram might improve the utilization of prediction tools in a clinical setting as it is easily applicable.

Keywords

Fournier’s gangrene severity index Outcome Mortality Predictive accuracy Nomogram 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • F. Roghmann
    • 1
    • 2
  • C, von Bodman
    • 1
  • Z. Tian
    • 2
  • M. Brock
    • 1
  • B. Löppenberg
    • 1
  • K. Braun
    • 1
  • A. Hinkel
    • 3
  • J. Palisaar
    • 1
  • J. Noldus
    • 1
  1. 1.Urologische UniversitätsklinikMarienhospital, Ruhr-Universität BochumHerneDeutschland
  2. 2.Cancer Prognostics and Health Outcomes UnitUniversity of Montreal Health CenterMontrealKanada
  3. 3.Urologische KlinikFranziskus HospitalBielefeldDeutschland

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