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Analysis of prognostic factors affecting poor outcomes in 41 cases of Fournier gangrene.

ABSTRACT: We present our experience involving the management of this disease, identifying prognostic factors affecting treatment outcomes. The patients treated for Fournier gangrene at our institution were retrospectively reviewed. Data collected included demographics, extent of soft tissue necrosis, predisposing factors, etiological factors, laboratory values, and treatment outcomes. The severity index and score were calculated. Multivariate regression analysis was used to determine the association between potential predictors and clinical outcomes. A total of 41 patients (male:female = 33:8) were studied. The mean age was 54.4 years (range, 24-79 years). The most common predisposing factor was diabetes mellitus (n = 19, 46.3%). Sixteen patients (39.0%) were current smokers. Seven patients had chronic kidney disease. The most frequent etiology was urogenital lesion (41.5%). The mortality rate was 22.0% (n = 9). Multivariate regression analyses showed that extension of necrosis beyond perineal/inguinal area and pre-existing chronic kidney disease were significant and independent predictors of mortality. Extension of necrosis beyond perineal/inguinal area was a significant predictor of increased duration in the intensive care unit and hospital stay. In addition, pre-existing chronic kidney disease was a significant predictor of flap reconstruction in the wound. Fournier gangrene with extensive soft tissue necrosis and pre-existing chronic kidney disease was associated with poor prognosis and complexity of patient management. Early recognition of dissemination and premorbid renal function is essential to reduce mortality and establish a management plan for this disease.

SUBMITTER: Hahn HM

PROVIDER: S-EPMC6255751 | biostudies-other | 2018 Dec

REPOSITORIES: biostudies-other

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Analysis of prognostic factors affecting poor outcomes in 41 cases of Fournier gangrene.

Hahn Hyung Min HM Jeong Kwang Sik KS Park Dong Ha DH Park Myong Chul MC Lee Il Jae IJ

Annals of surgical treatment and research 20181126 6

<h4>Purpose</h4>We present our experience involving the management of this disease, identifying prognostic factors affecting treatment outcomes.<h4>Methods</h4>The patients treated for Fournier gangrene at our institution were retrospectively reviewed. Data collected included demographics, extent of soft tissue necrosis, predisposing factors, etiological factors, laboratory values, and treatment outcomes. The severity index and score were calculated. Multivariate regression analysis was used to ...[more]

PMID: 30505824

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Analysis of prognostic factors affecting poor outcomes in 41 cases of Fournier gangrene.

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Analysis of prognostic factors affecting poor outcomes in 41 cases of Fournier gangrene.

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