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Low magnesium levels an important new prognostic parameter can be overlooked in patients with Fournier’s gangrene: a multicentric study

  • Urology - Original Paper
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Abstract

Introduction

We evaluated low magnesium levels and three different scoring systems including the Fournier’s Gangrene Severity Index (FGSI), the Uludag Fournier’s Gangrene Severity Index (UFGSI), and the Charlson Comorbidity Index (CCI) for predicting mortality in a multicentric, large patient population with FG.

Methods

The medical records of 99 FG patients who were treated and followed up in different clinics were reviewed. The biochemical, hematological, and bacteriological results from the admission evaluation were recorded. The CCI, FGSI, and UFGSI were evaluated and stratified by survival.

Results

The results were evaluated for the following patients: the survivors (n = 82) and the nonsurvivors (n = 17). The magnesium level for the survivors and nonsurvivors was 2.09 ± 0.28 and 1.68 ± 0.23, respectively (p 0.004). The admission FGSI, UFGSI, and CCI scores were significantly higher in nonsurvivors (p 0.001, p 0.001, p < 0.001, respectively). The receiver operating characteristics analysis revealed that the UFGSI was more powerful than the FGSI. The hypomagnesemia, low hemoglobin and hematocrit, low albumin and HCO3 levels; high alkaline phosphatase; and the high heart and respiratory rates, an FGSI >9, rectal involvement, and a high CCI were associated with a worse prognosis.

Conclusion

Low magnesium levels might be an important parameter for a worse FG prognosis. Monitoring the serum magnesium levels might have prognostic and therapeutic implications in patients with FG. High CCI, FGSI, and UFGSI scores might be associated with a worse prognosis in patients with FG. The UFGSI might be more powerful scoring system than the FGSI.

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Authors and Affiliations

  1. Department of Urology, Istanbul Medeniyet University Faculty of Medicine, Dr. Erkin Cad. Istanbul Medeniyet Universitesi Goztepe Eğitim Arastirma Hastanesi, Kadikoy/Istanbul, Turkey

    Bulent Erol, Utku Sari, Furkan Sendogan, Asif Yildirim & Turhan Caskurlu

  2. Department of Urology, Ankara Numune Training and Research Hospital, Ankara, Turkey

    Altug Tuncel

  3. Department of Urology, Bulent Ecevit University Faculty of Medicine, Zonguldak, Turkey

    Adem Tok

  4. Department of Anesthesiology, Dokuz eylul University Faculty of Medicine, Izmir, Turkey

    Volkan Hanci

  5. Department of Urology, Izmir Tepecik Training and Research Hospital, Izmir, Turkey

    Salih Budak

  6. Department of Urology, Sakarya Training and Research Hospital, Sakarya, Turkey

    Huseyin Aydemir

  7. Department of Urology, Adnan Menderes University, Faculty of Medicine, Aydin, Turkey

    Akin Soner Amasyali

Authors
  1. Bulent Erol
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  2. Altug Tuncel
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  3. Adem Tok
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  4. Volkan Hanci
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  5. Utku Sari
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  6. Furkan Sendogan
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  7. Salih Budak
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  8. Huseyin Aydemir
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  9. Akin Soner Amasyali
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  10. Asif Yildirim
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  11. Turhan Caskurlu
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Corresponding author

Correspondence to Bulent Erol.

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Ethical standard

The Ethics Committee of our faculty approved the study protocol (2015/0069).

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Erol, B., Tuncel, A., Tok, A. et al. Low magnesium levels an important new prognostic parameter can be overlooked in patients with Fournier’s gangrene: a multicentric study. Int Urol Nephrol 47, 1939–1945 (2015). https://doi.org/10.1007/s11255-015-1131-9

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  • DOI: https://doi.org/10.1007/s11255-015-1131-9

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