Etiological factors and treatment outcome of genital and perineal necrotizing fascitis [Fournier's gangrene]

ABSTRACT

To analyze clinical and laboratory parameters in patients with Fournier's gangrene [FG] and to assess factors that determine mortality. A retrospective review of 82 patients with FG from January 2007 to December 2011 was made. They were divided into two groups those who survived [survivors] and those who did not [non survivors]. We analyzed clinical and laboratory data. The mortality rate remained 36.6% [30/82 patients]. Increased heart and respiratory rates, elevated serum creatinine, pre-existing kidney disease, and higher extent of affected body surface were associated with higher mortality. Severe sepsis on admission and hypotension < 90 mm Hg] were also predictive for higher mortality. The median FG severity index [FGSI] score was higher in non survivors [22 vs 12, p < 0.0001]. Besides standard clinical and laboratory parameters included in the FGSI calculation, higher extent of affected body surface area and presence of hypotension on admission were positively associated with mortality. Early clinical identification and prompt aggressive treatment are essential for reducing mortality and morbidity in patients