Evaluation of Risk Factors and Severity of a Life Threatening Surgical Emergency: Fournier’s Gangrene (A Report of 15 Cases)

Abstract

Aggressive surgical debridement and combined antibiotherapy are essential in the management of Fournier's gangrene. FGSI and BSA are useful to assess the severity and prognosis of the disease.

Prospective evaluation of risk factors for mortality in patients of Fournier′s gangrene: A single center experience

“…Its association with increased mortality is controversial. [8161718] There is similar uncertainty about the association of age and mortality. [819202122] Ischemic heart disease and CRF, specially hemodialysis dependence, seem to be significantly associated with mortality.…”

Contemporary diagnosis and management of Fournier’s gangrene

“…Kabay and colleagues analyzed patients using this index and showed those with FGSI greater than 10.5 had 96% mortality whereas those with a score less than 10.5 had 96% survival [Kabay et al 2008]. Kara and colleagues found that FGSI scores of at least 7 affected mortality rates with statistical significance (p < 0.05) and Altarac and colleagues noted that FGSI scores were significantly higher among nonsurvivors (11 versus 5, p < 0.0001) [Kara et al 2009;Altarac et al 2012]. However, controversy exists regarding the accuracy of FGSI, as Tuncel and colleagues and Janane and colleagues argued the index cannot be relied upon to predict survival [Tuncel et al 2006;Janane et al 2011].…”

“…The presence of severe sepsis on admission has been significantly associated with mortality [Kara et al 2009;Altarac et al 2012]. Additionally, the volume of necrosis appears to be a prognostic factor as some studies show patients with a gangrenous area less than 3% of the body surface rarely die, whereas patients presenting with a gangrenous area of 5% body surface area or more have a worse prognosis [Dahm et al 2000;Horta et al 2009;Janane et al 2011].…”

“…Various comorbidities are known to be associated with FG, of which DM is most common. However, its association with increased mortality is debatable [Kabay et al 2008;Unalp et al 2008;Kara et al 2009;Ersoz et al 2012]. Similarly, there is uncertainty about the association of age and mortality in FG [Yeniyol et al 2004;Tuncel et al 2006;Lujan et al 2010].…”

“…A score greater than 9 is suggested to have a 75% probability of death, and index score up to 9 is associated with a 78% probability of survival. FGSI has been validated by several studies [Chawla et al 2003;Yeniyol et al 2004;Kabay et al 2008;Unalp et al 2008;Kara et al 2009;Altarac et al 2012]. Kabay and colleagues analyzed patients using this index and showed those with FGSI greater than 10.5 had 96% mortality whereas those with a score less than 10.5 had 96% survival [Kabay et al 2008].…”