ABSTRACT
INTRODUCTION: Fournier's gangrene (FG) is the necrotizing fasciitis of the perineum and genital area with high mortality. MATERIALS AND METHODS: A retrospective review included 41 patients diagnosed with FG in our hospitals from 1995 to 2010, divided into survivors and nonsurvivors. We analyzed anamnestic, clinical and laboratory data. RESULTS: The mortality rate was 36.6% (15/41 patients). Elevated heart and respiratory rates, high serum creatinine, low serum bicarbonate, pre-existing kidney disease, and higher median extent of affected body surface were associated with higher mortality. Severe sepsis on admission and hypotension below 90 mm Hg were also predictive for higher mortality. The median FG severity index (FGSI) score was higher in nonsurvivors (11 compared to 6, p < 0.0001). No cases of testicular necrosis were noted. CONCLUSION: 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 also positively associated with mortality.
Subject(s)
Fournier Gangrene/etiology , Fournier Gangrene/therapy , Adult , Aged , Aged, 80 and over , Chi-Square Distribution , Croatia , Female , Fournier Gangrene/diagnosis , Fournier Gangrene/microbiology , Fournier Gangrene/mortality , Humans , Male , Middle Aged , Retrospective Studies , Risk Assessment , Risk Factors , Severity of Illness Index , Slovenia , Time Factors , Treatment OutcomeABSTRACT
Fournier's gangrene (FG) is a rare form of the skin and subcutaneous tissue bacterial infection characterized clinically by rapid progression and significant mortality, patohistologically by extensive necrosis of supeficial and deep facial planes and epidemiologically by predilection to patients with diabetes, immunosupression, malignant diseases or other debilitating state. In our retrospective study, we analyze 17 patients with FG hospitalised in our hospital in the 16-year period. Mean age of the patients was 58.9, and female-to-male ratio was 1:16. Among the predisposing factors diabetes mellitus (41.2%) and malignant diseases (29.4%) were the most common. Average length of hospital stay was 36 days (2-81) with lethality of 41.2% (7 patients). We assessed no statistical significance of the analysed prognostic parameters. In conclusion, we emphasize that FG is a surgical emergency and we express our impression that lack of physicians' experience is the main factor leading to delay in diagnosis and treatment of this rare, but life threatening disease.
