Korean J Urol.
2002 May;43(5):412-417.
The Study of Prognostic Factors in Fournier's Gangrenes
- Affiliations
-
- 1Department of Urology, Wonkwang University School of Medicine, Iksan, Korea. uro94c@wmc.wonkwang.ac.kr
Abstract
- PURPOSE
Fournier's gangrene is a rapidly progressive necrotizing fascitis involving the genitalia. It is most commonly associated with diabetes mellitus or a local perineal abscess. The factors governing survival from Fournier's gangrene have not been clearly identified. Therefore, we evaluated prognostic factors, clinical characteristics and treatment during the last 10 years, comparing medical records between survivors and non-survivors of Fournier's gangrene.
MATERIALS AND METHODS
We treated 25 patients with Fournier's gangrene during a 10-year period. Medical records were reviewed with respect to age at presentation, extent of disease, physical examination, laboratory studies and bacteriology, associated disease, clinical course and therapy. The extent of the disease was quantified for each patient by applying a modified diagram used to assess the extent of burn injuries.
RESULTS
Of 25 patients, 9 died (36%) and 16 survived (64%). Anorectal infections were the most common cause, along with high mortality (75%). The most common underlying disease was diabetes. When the duration of symptoms, before hospitalization, was more than 10 days, the mortality rate was 57%. Patients with <6% surface area involvement were more likely to survive (p<0.05). The mortality rate of patient with a serum blood urea nitrogen (BUN) level of more than 40mg/dl, or serum creatinine level of more than 1.5mg/dl, was 42.9, and 54.5% (p<0.05), respectively.
CONCLUSIONS
Survival was associated significantly with anorectal infection, duration of symptoms before hospitalization, extent of gangrene, serum BUN and creatinine levels. However, survival was not associated with diabetes or bacteriological factors.
