Fournier’s gangrene: a modern analysis of predictors of outcomes

Sparenborg, Jeffrey D.; Brems, Jacob; Wood, Andrew; Hwang, Jonathan; Venkatesan, Krishnan

doi:10.21037/tau.2019.03.09

Cited by 34 publications

(39 citation statements)

References 23 publications

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“…It has been reported that there was a 75% probability of death in patients with a score of FGSI greater than 9 [6]. The benefit of the FGSI has been also shown by other studies [3,8,9,11,12,16,20]. However, some researchers showed that there was no significant association between FGSI and mortality [10,13].…”

Section: Discussionmentioning

confidence: 82%

“…In most of the previously published studies, the presence of DM in patients with FG has been shown as one of the major prognostic factors for morbidity and mortality [1,16,[20][21][22]. Nevertheless, some researchers did not report significant associations between DM and FG [2,3,19].…”

Section: Discussionmentioning

confidence: 99%

“…However, heterogeneity in study populations and unstandardized variables may prevent generalizability of the results. It has been thought that the mortality rates of FG has been also lowered to 10% or less with the advancement of early diagnosis and improved treatment modalities within the last decades [5,14,16]. However, mortality rates have been found between 35 and 67% [17].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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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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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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“…The most studied comorbid factors are diabetes mellitus, history of alcohol, age, the bacteria that causes Fournier's gangrene and others. 5 This retrospective study examined the factors that exist in patients towards the successful closure of defects in Fournier's gangrene. In this study, various factors such as age, smoking status, alcohol history, diabetes mellitus, hypertension, and bacteria that cause infections to successfully close defects in Fournier's gangrene were investigated.…”

Section: Discussionmentioning

confidence: 99%

Predisposition Factors Analysis for Fournier’s Gangrene Defects Closure Complication

Bermani

Rizaliyana

Handriani

2021

JRE

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Background: Fournier’s gangrene is a rare and rapidly progressive, necrotizing fasciitis affecting the external genitalia and perineum. Based on the case series that have been reported, the incidence rate of this case is 88% with mortality rate of 20%-40%. The study aims to share our policy in managing Fournier’s gangrene and identifying risk factors that can affect the outcome of defect closure.Method: The medical records of 10 patients with Fournier’s gangrene who presented at the Dr. Soetomo Hospital Surabaya from January 2017 to December 2018 were reviewed retrospectively. We analyzed characteristics of the patients, risk factors, methods of defect closure, and case outcome. There are 10 Fournier’s gangrene patients at Dr. Soetomo Academic General Hospital from January 2017 to December 2018. We analyzed the patient’s medical records retrospectively on the patient’s characteristics, risk factors, method of closing Fournier’s gangrene defects, and the final outcome of the case.Results: There were ten men enrolled in the study, and the mean age was 49.3 ± 11.51 years. All patients received broad-spectrum antibiotic therapy, and extensive surgical excision. This study found that diabetes mellitus and uncontrolled patient blood sugar levels, statistically there is no effect on failure of defect closure in Fournier gangrene patients, but clinically, the relative risk value shows that blood glucose levels have a risk factor of 6 times. increasing the incidence of failure to close the Fournier gangrene defect.Conclusions: Fournier’s gangrene is still considered a severe disease with fairly high mortality rate. Early recognition of predisposition factors associated with invasive and aggressive treatment options is very important in efforts to to reduce morbidity.

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“…1). Uludag Fournier's Gangrene severity Index (UFGsI) [9,10]. Some authors apply adjuvant hyperbaric oxygen therapy or vacuum assisted therapy [11].…”

Section: Case Presentationmentioning

confidence: 99%

Supralevator Abscess Complicated by Necrotic Fasciitis of Peritoneum, Genitalia, Anterior Abdominal Wall and Retroperitoneum.

Hadzhieva

Chakarov

Moshekov

et al. 2021

AJTES

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A supralevator anorectal abscess may lead to a rare clinical complication, such as perineal necrotizing fasciitis. A 57-year-old man was admitted on an emergency basis with evidence of a deep anorectal abscess of 5-day duration. The clinical presentation involved an unbounded purulent destructive inflammation spreading onto the adjacent areas, with the development of a septic condition. Following a short preparation, a radical surgical debridement of a subfascial purulent necrotic phlegmon of the pelvic space was performed. Since the lower part of the abdomen, retroperitoneum and scrotum were involved, 4 additional subsequent necrectomies were performed at 48-hour intervals. The aggressive radical operative treatment and the combined intensive therapy were the main contributors to the favorable outcome of the disease.

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Fournier’s gangrene: a modern analysis of predictors of outcomes

Cited by 34 publications

References 23 publications

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

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

Predisposition Factors Analysis for Fournier’s Gangrene Defects Closure Complication

Supralevator Abscess Complicated by Necrotic Fasciitis of Peritoneum, Genitalia, Anterior Abdominal Wall and Retroperitoneum.

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