IMPORTANCE OF SEVERITY SCORES: OUR RESULTS IN FIFTY-TWO PATIENTS
Yusuf Tanrikulu, Mithat Cagsar, Gokhan Yilmaz, Ceren Sen Tanrikulu
article (Uluslararası, Hakemli) | Yazar(lar): Yusuf Tanrikulu, Mithat Cagsar, Gokhan Yilmaz, Ceren Sen Tanrikulu | Yıl: 2015 | Dergi/Kurum: ACTA MEDICA MEDITERRANEA | İndeks: WOS.SCI | Anahtar Kelimeler: Fournier's gangrene, FGSI, mortality, soft tissue infections — Özet: Background: Fournier's gangrene (FG) is a rare,
Background: Fournier's gangrene (FG) is a rare, an acute, rapidly progressive, fatal necrotizing fasciitis of the genital, perianal and perineal areas. The incidence of mortality is still high, and mortality increases with age. In this study we purposed our experience in the treatment of FG and to determine risk factors affecting prognosis.
Methods: Fifty-two patients operated for FG who presented at our hospital from January 2009 to December 2014 were investigated retrospectively. Patients were divided into two groups; surviving and non-surviving. Groups were compared regarding demographic features, vital signs and laboratory analysis, PG severity scores and surgical treatment requirements.
Results: Mean age was 56.4 years, and female/male ratio was 20/32. The mortality rate was 9.6% (5 patients), and significantly higher in men (80%). The two most common etiological factors were soft tissue infection (63.5%) and anorectal diseases (28.8%). There was difference between groups in terms of requirements fecal diversion, respiratory rate, potassium and urea levels (p<0.05). There was significant difference between groups according to the FG severity index (FGSI) and illudag FGSI (respectively p=0.001 and p=0.002). There were no significant difference between groups according to the duration of symptoms and hospitalization, use of antibiotic, etiology, wound culture and debridement number.
Conclusions: FG is an unpredictable fulminant disease and there is need for new proposals to reduce morbidity and mortality. In our study, male gender, hypokalemia, uremia and increased respiratory rate at first presentation, and having a neurological disease were found to be the factors affecting mortality in FG patients.