Usefulness of Fournier Gangrene Severity Index in Managing the Patients at Viet Duc Hospital
Keywords:
Fournier’s Gangrene, Fournier Gangrene Severity Index, Necrotizing tissuesAbstract
Purpose: Fournier’s gangrene is a life-threatening necrotizing infection of the perineal, perianal, and periurethral tissues that can disseminate even at the subcutaneous tissue of the thigh. In this study, we identified prognostic factors for survival and validated the accuracy of the Fournier’s gangrene severity index (FGSI) in patients with Fournier’s gangrene.
Materials and Methods: We retrospectively reviewed medical records of patients diagnosed with Fournier’s gangrene between 2009 and 2014. FGSI scores were assessed using a receiver operating characteristic curve. An outcome variable of inpatient mortality, univariate analyses were performed by SPSS 18.0.
Results: A total of 27 patients (92.6% male, mean age 50.3 ± 14 years) diagnosed with Fournier’s gangrene met the criteria for review. The overall mortality rate was 14.8% (4 patients). FGSI ≥ 9 was 14.8% vs < 9 was 85.2%. Survival of the group with FGSI ≥ 9 was only 1/4 (25%) versus 22/23 (95.7%) in the group with FGSI < 9. The mean FGSI score for survivors was 3.57 ± 2.57 versus 10.5 ± 2.6 for nonsurvivors (p < 0.001). Using a FGSI score threshold of 9 (sensitivity 71.4%, specificity 90%) there was a 96% survival rate in patients with FGSI of less than 9 and a 46% mortality rate in those with FGSI of 9 or greater (RR = 17.25).
Conclusions and Recommendations: The FGSI remains an objective and simple method to quantify the extent of metabolic aberration at presentation in patients with Fournier’s gangrene. FGSI threshold value of 9 is sensitive and specific for predicting mortality in this patient population and could be used for the clinical managements of FG.
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