Validation of the Fournier's Gangrene Severity Index in a Large Contemporary Series

Corcoran, Anthony; Smaldone, Marc C.; Gibbons, Erin; Walsh, Thomas J.; Davies, Benjamin

doi:10.1016/j.juro.2008.05.021

Cited by 148 publications

(170 citation statements)

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“…On the contrary, some other studies have not shown any difference between survivors and non-survivors as for the time to admission. [7,11] Furthermore, in their studies McCormack et al [19] determined that the time be- Logically, an increased body percent involved would cause sepsis and result in an increased risk for mortality, however two studies proposed that the extent of the disease was not predictive of outcome. [2,4] Three separate studies found significantly higher incidence of the disease in body in the non-survivors.…”

Section: Discussionmentioning

confidence: 99%

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Overview of different scoring systems in Fournier’s Gangrene and assessment of prognostic factors

Doluoğlu

Karagöz

Kılınç

et al. 2016

Turkish Journal of Urology

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Objective: In this study we aimed to evaluate prognostic factors for the survival of patients with Fournier's gangrene (FG), and overview different validated scoring systems for outcome prediction. Material and methods:We retrospectively analyzed the data of 39 patients treated for FG in our clinic. Data were collected on medical history, symptoms, physical examination findings, vital signs, laboratory parameters at admission and at the end of treatment, timing and extent of surgical debridement, and the antibiotic treatment used. The Fournier's Gangrene Severity Index (FGSI) and Charlson Comorbidity Index (CCI) were used to predict outcome. The data were analyzed in relation with the survival of the patients. Mann-Whitney U test, chi -square test, Wilcoxon signed rank test, and Cox regression analysis were used for the statistical analysis.Results: Of 39 patients analyzed, 8 (20.5%) died and 31 (79.5%) survived. The median FGSI score on admission was 2 (0-9) for the survivors and 6 (2-14) for the non-survivors (p=0.004). The median CCI scores of the survivors and non-survivors were 2 (0-10) and 6.5 (5-11), respectively (p=0.001). Except for urea, albumin and hematocrit levels, no significant differences were found between survivors and non-survivors for other laboratory parameters on admission. Lower albumin levels and advanced age were found to be associated with mortality. Conclusion:High blood urea, low albumin, and low hematocrit levels were associated with poor prognosis. High CCI and FGSI scores could be associated with a poor prognosis in patients with FG.

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Section: Discussionmentioning

confidence: 99%

“…[2] Although some studies in the literature supported these findings, some others claimed that FGSI scores were not different between survivors and non-survivors. [7][8][9][10][11] Charlson Comorbidity Index (CCI) has been also used in addition to FGSI to predict the prognosis in FG. [12] However, their reliabilities are not yet clear.…”

Section: Introductionmentioning

confidence: 99%

Overview of different scoring systems in Fournier’s Gangrene and assessment of prognostic factors

Doluoğlu

Karagöz

Kılınç

et al. 2016

Turkish Journal of Urology

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“…In a large retrospective study of 68 patients, Corcoran et al 25 described significant differences between non-survivors and survivors on admission laboratory parameters. Non survivors had high serum creatinine and lactate, and low serum calcium.…”

Section: Figure I: Resultsmentioning

confidence: 99%

Clinical & Microbiological profile of Fourniers Gangrene in a Tertiary Care Hospital in Bangladesh : A prospective observational study

Maitra

Ekramullah

Shabnam

et al. 2017

Bangladesh Crit Care J

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Background: Fourniers gangrene is the necrotising fasciitis of the genitalia and perineum, with associated poly microbial infection. Evidence based data in the very recent years suggest that it is associated with significant and potential risk of organ failure or death.Aim: This study was designed to be conducted among the patients suffering from Fourniers gangrene with a view to assess the probable prevalence rate of potentially adverse clinical consequences during course of treatment, overall mortality and to observe the microbiological pattern in our surgical practice.Method & materials: This cross sectional study was conducted among the 69 patients of Fourniers gangrene in BIRDEM General Hospital, Dhaka, Bangladesh from Jan 10.2013 to Sept 01 .2016, using the purposive sampling method.Results: The results of this study reflects that majority (43.4%) of the study population were in 51 to 60 years age group( Mean age 43±1.7 years) in study population. By using the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score, it was found that in most of the patients (approx 56.5%), a suspicious score ranging 06-08 was observed and only in 10.1% patients, a specific score of ?08 was observed. In 27.5% patients systemic complications like DIC, ARDS, MODS, MSOF and severe sepsis were observed in 1.4%, 4.3%, 10.1%, 4.3% and 5.7% cases respectively. Mortality rate was approximately 4.3%. Majority (84.1%) of the patients were associated with type 1 (Polymicrobial) bacterial infection, whereas in case of 15.9% patients, it was associated with type 2 (Monomicrobial) infection. Escherichia coli was the most frequently observed micro-organisms associated with approximately 39.1% of all cases. S. aureus, Staphylococcus pyogenes, Enterococci species, E.coli and Pseudomonas species were recorded to be associated with 17.4%, 27.5%, 21.7%, 39.1 and 10.1% cases respectively.Conclusion: This study suggests that Fourniers gangrene is associated with significant systemic complications. Poly microbial infections are most predominant and E coli infection was commonest organism involved.Bangladesh Crit Care J March 2017; 5(1): 28-32

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Section: Discussionmentioning

confidence: 99%

“…[1][2][3]16 Mortality rates between 4% and 46% have been reported. [1][2][3]16 Early aggressive serial debridement and intravenous antibiotics, followed by some form of durable wound coverage, is standard therapy. [1][2][3]14,15,17 Because most patients with Fournier's gangrene are older with comorbidities, comesis may not be a primary consideration in the reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Aesthetic scrotal reconstruction following extensive Fournier’s gangrene using bilateral island pedicled sensate anterolateral thigh flaps: A case report

Dayan

Clarke-Pearson

Dayan

et al. 2014

CUAJ

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Achieving an aesthetic appearance of the scrotum after extensive Fournier's gangrene is a reconstructive challenge. Testicular coverage is often prioritized over scrotal cosmesis due to the comorbidities typically seen in this patient population. We describe our treatment of a young, healthy male with extensive Fournier's gangrene, with loss of the scrotum. Bilateral neurotized anterolateral thigh flaps were used to achieve a sensate and aesthetically acceptable result.

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Validation of the Fournier's Gangrene Severity Index in a Large Contemporary Series

Cited by 148 publications

References 18 publications

Overview of different scoring systems in Fournier’s Gangrene and assessment of prognostic factors

Overview of different scoring systems in Fournier’s Gangrene and assessment of prognostic factors

Clinical & Microbiological profile of Fourniers Gangrene in a Tertiary Care Hospital in Bangladesh : A prospective observational study

Aesthetic scrotal reconstruction following extensive Fournier’s gangrene using bilateral island pedicled sensate anterolateral thigh flaps: A case report

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Validation of the Fournier's Gangrene Severity Index in a Large Contemporary Series

Cited by 148 publications

References 18 publications

Overview of different scoring systems in Fournier’s Gangrene and assessment of prognostic factors

Overview of different scoring systems in Fournier’s Gangrene and assessment of prognostic factors

Clinical & Microbiological profile of Fourniers Gangrene in a Tertiary Care Hospital in Bangladesh : A prospective observational study

Aesthetic scrotal reconstruction following extensive Fournier’s gangrene using bilateral island pedicled sensate anterolateral thigh flaps: A case report

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Clinical & Microbiological profile of Fourniers Gangrene in a Tertiary Care Hospital in Bangladesh : A prospective observational study