The Prognostic Factors and Severity Index in Fournier's Gangrene.

, Kim, Kwang Min; , Seong, Seung Hoon; , Won, Dal Yeon; , Ryu, Hoon; , Kim, Ik Yong

doi:2010.26.1.29

Original Article

Journal of the Korean Society of Coloproctology 2010;26(1):29-33.
DOI: https://doi.org/10.3393/jksc.2010.26.1.29

The Prognostic Factors and Severity Index in Fournier's Gangrene.

Kim, Kwang Min , Seong, Seung Hoon , Won, Dal Yeon , Ryu, Hoon , Kim, Ik Yong

Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea. iykim@yonsei.ac.kr

Abstract

PURPOSE
Fournier's disease is polymicrobial necrotizing fasciitis of the perineal, perianal, or genital areas. The objective of this study was to investigate patients with Fournier's gangrene and to determine risk factors that affect mortality.
METHODS
This study was a retrospective clinical study. Clinical presentations and outcomes of surgical treatments were evaluated in 27 patients with Fournier's gangrene that were treated in a single institution from January 2000 to March 2009.
RESULTS
The mean age of patients was 52.8+/-14.4 yr, and the male-to-female ratio was 25:2. Among the predisposing factors, diabetes mellitus was the most common (n=8, 29.6%). The most common infection source was anorectal (n=16, 59.3%). Sepsis on admission was detected in 16 cases (59.3%). Four patients died during treatment, for an overall mortality of 14.8%. A logistic regression test showed a Fournier's gangrene severity index greater than 9 and sepsis on admission to be prognostic factors.
CONCLUSION
The mortality rate was higher in patients with sepsis on admission and with a Fournier's gangrene severity index greater than nine.