Risk factors for mortality in fournier’s gangrene in a general hospital: use of simplified founier gangrene severe index score (SFGSI)

Vol. 43 (x): 2017 August 8.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2017.0193


ORIGINAL ARTICLE

Carlos Eugênio Lira Tenório 1, 2, Salvador Vilar Correia Lima 1, 3, Amanda Vasconcelos de Albuquerque 3, Mariana Pauferro Cavalcanti 2, Flávio Teles 2
1 Serviço de Urologia do Hospital das Clínicas, Departamento de Cirurgia do Centro de Ciências da Saúde da Universidade Federal de Pernambuco, UFPE, Recife, PE, Brasil; 2 Faculdade de Medicina da Universidade Estadual de Ciências da Saúde de Alagoas (UNCISAL), Maceió, AL, Brasil; 3 Núcleo de Cirurgia Experimental, Programa de Pós-Graduação em Cirurgia, Departamento de Cirurgia, Centro de Ciências da Saúde, Universidade Federal de Pernambuco, UFPE, Recife, PE, Brasil

ABSTRACT

Objective: To evaluate risk factors for mortality in patients with Fournier’s gangrene (FG), with emphasis in the Simplified Fournier Gangrene Severe Index Score (SFGSI).

Materials and Methods: This was a cross-sectional study that was carried out from January 2010 to December 2014, with 124 patients treated for FG in a General Hospital. Several clinical and laboratory variables, including SFGSI, were evaluated and corre­lated with mortality through univariate analysis and logistic regression.

Results: Of the 124 patients, 99 were men (79.8%), the mean age was 50.8±19.5 years and the main comorbidity was diabetes mellitus (51.6%). The mortality rate was 25.8%. Variables that presented independent correlation with mortality were the extension of the lesion to the abdomen (OR=4.0, CI=1.10-14.68, p=0.03), hematocrit (OR=0.81, CI=0.73-0.90, p<0.0001), potassium (OR=2.41, CI=1.13-5.10, p=0.02) and creatinine (OR=2.15, CI=1.04-4.41, p=0.03). When hematocrit, potassium and creatinine were tested together, as part of the SFGSI, a >2 result was the largest of the independent predictors of mortality (OR=50.2; CI=13.18-191.47; p<0.0001).

Conclusion: The SFGSI >2 presented a higher correlation with mortality than any variable tested alone. It seems to be a promising alternative to evaluate predictors of mortality in Fournier’s gangrene. The main advantage is easy applicability because it contains only three parameters and can be used immediately after patient’s admission.

Keywords: Fournier Gangrene; Risk Factors; Mortality; Fasciitis, Necrotizing

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