New Prognostic Factors in Fournier’s Gangrene: 10 Years Experience

Abstract

Introduction: We have evaluated the prognostic and risk factors of the Fornier's gangrene.

Methods: 71 patients referred to Ghaem hospital during 1998- 2008 were reviewed in this study and evaluated for lab parameters (Urea, Cr, Hct, WBC, Alb, Na, Ca, and K) as well as probable risk factors.

Results: Mean age was 60.85 ± 17.02 years and the time between onset of symptoms and referring to a health care unit was 6.7±5.25. The sources of infection were skin (%35), urogenital (%48), and rectal (%17). Sixty of the patients were in the deceased group and comparing the mean temprature at the time of admission, respiratory rate and heart rate of the two groups, there was no significant difference between the survived and deceased groups. The difference was not significant between deceased and survived patients for WBC, Na, K, and Cr, while it was significant comparing Alb, Ca and level of extention.

Conclusion: Comparing the results of our study with conventional index, known as “Laor Fournier's gangrene severity index”, none of the implied indices in this study such as temperature, heart rate, respiratory rate, Hct, Cr, WBC, Na, Ca, had the prognostic value in comparison of deceased and survived group. While in our study the confirmed prognostic factors were as follows: time between onset and referring to hospital, age, source of infection (poor prognosis when rectal as the source) and level of extension, Alb, urea, Ca, and number of required debridements.