Can We Predict Mortality in Patients with Fournier’s Gangrene Using Questionnaires? A Pilot Study with Eighty-seven Patients

Islamoglu, Ekrem; YALÇINKAYA, Soner; ates, nihat; TOKGÖZ, Hüsnü; YÜKSEL, MUSTAFA; savas, murat; yildiz, ali

doi:10.4274/jus.galenos.2018.2327

Can We Predict Mortality in Patients with Fournier’s Gangrene Using Questionnaires? A Pilot Study with Eighty-seven Patients

Soner YALÇINKAYA, (University of Health Sciences, Antalya Training and Research Hospital, Clinic of Urology, Antalya, Turkiye)

Ali YILDIZ, (University of Health Sciences, Antalya Training and Research Hospital, Clinic of Urology, Antalya, Turkiye)

Mustafa YÜKSEL, (University of Health Sciences, Antalya Training and Research Hospital, Clinic of Urology, Antalya, Turkiye)

Ekrem İSLAMOĞLU, (University of Health Sciences, Antalya Training and Research Hospital, Clinic of Urology, Antalya, Turkiye)

Nihat ATEŞ, (University of Health Sciences, Antalya Training and Research Hospital, Clinic of Urology, Antalya, Turkiye)

Hüsnü TOKGÖZ, (University of Health Sciences, Antalya Training and Research Hospital, Clinic of Urology, Antalya, Turkiye)

Murat SAVAŞ (University of Health Sciences, Antalya Training and Research Hospital, Clinic of Urology, Antalya, Turkiye)

Journal of Urological Surgery

2 0

Yıl: 2019 Cilt: 6 Sayı: 2 Sayfa Aralığı: 118 - 124 Metin Dili: İngilizce DOI: 10.4274/jus.galenos.2018.2327 İndeks Tarihi: 25-06-2020

Can We Predict Mortality in Patients with Fournier’s Gangrene Using Questionnaires? A Pilot Study with Eighty-seven Patients

Öz:

Objective: To investigate the validity and reliability of the Fournier’s gangrene severity index (FSGI) and Uludag Fournier’s gangrene severity index(UFGSI) scoring systems and their components in outcome prediction for patients with Fournier’s gangrene.Materials and Methods: Recods of 87 patients, who were diagnosed with Fournier’s gangrene in our clinic between March 2005 and May 2016,were retrospectively analyzed. The patients were divided into 2 groups as survivors and non-survivors. Parameters belonging to the groups werecompared.Results: The overall mortality rate was 13.7%. There was no correlation between mortality and dissemination of disease to the rectum, lowerabdomen or lower extremity (p>0.05). There was a significant difference in renal failure, heart rate, blood urea nitrogen, creatinine, calcium andserum bicarbonate (HCO₃) values, and FSGI and UFGSI scores between the survivor and non-survivor groups (p<0.05). In evaluation of mortality,a cut-off value of ≥9 had a positive predictive value of 77.8% and 42.9% and negative predictive value of 93.6% and 95.5% for FGSI and UFGSI,respectively.Conclusion: To predict the prognosis in Fournier’s gangrene, the FGSI and UFGSI are successful parameters especially in predicting mortality. In thelight of these parameters, we assume that these scoring systems are useful in deciding which patient should receive more aggressive treatment.

Anahtar Kelime:

Fournier Gangrenine Bağlı Ölümleri Anketlerle Öngörebilir miyiz? Seksen Yedi Hastayla Yapılan Pilot Bir Çalışma

Öz:

Amaç: Fournier’s gangrene severity index (FGSİ) ve Uludag Fournier’s gangrene severity index (UFGSİ) skorlama sistemlerinin ve komponentlerinin Fournier gangrenini değerlendirmedeki geçerliliklerini ve güvenilirliklerini değerlendirmek. Gereç ve Yöntem: Mart 2005 ve Mayıs 2016 tarihleri arasında, kliniğimizde Fournier gangreni tanısı alan 87 hastanın kayıtları retrospektif olarak incelendi. Hastalar hayatta kalanlar ve kalmayanlar olarak iki gruba ayrıldı. Her iki gruba ait parametreler birbiriyle karşılaştırıldı. Bulgular: Tüm hastalardaki mortalite oranı %13,7 idi. Mortalite ile hastalığın rektuma, alt abdomene veya alt ekstremiteye yayılması arasında anlamlı bir bağlantı bulunamadı (p˃0,05). Hayatta kalanlar ve kalmayanlar grupları arasında; böbrek yetmezliği, kalp atım hızı, kan üre nitrojeni, kreatinin, kalsiyum ve serum bikarbonat (HCO₃) değerleriyle birlikte FGSİ ve UFGSİ skorlarında anlamlı bir farklılık vardı (p˂0,05). Eşik değer 9 olarak kabul edildiğinde; FGSİ’nin mortalite için pozitif ve negatif prediktivitesi sırasıyla %77,8 ve %93,6; UFGSİ’nin ise sırasıyla %42,9 ve %95,5 olarak hesaplandı. Sonuç: FGSİ ve UFGSİ, Fournier gangreni hastalarının prognozunu öngörmek, özellikle de hastalığın mortalitesinin negatif prediktivitesini hesaplamak için çok başarılı skorlama sistemleridir. Bu bilgiler ışığında, bazı hastalara ilk aşamada daha agresif tedaviler başlamak akıllıca bir yaklaşım olacaktır.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Vick R, Carson CC. Fournier’s disease. Urol Clin North America 1999;26:841- 849.
2. Pawlowski W, Wronski M, Krasnodebski IW. Fournier’s gangrene. Pol Merkur Lekarski 2004;17:85-87.
3. Yeniyol CO, Suelozogen T, Arslan M, Ayder RA. Fournier’s gangrene: experience with 25 patients and the use of Fournier’s gangrene severity index score. Urology 2004;64:218-222.
4. Shanker M, Singhal V, Singh JP, Bansal A, Saxena S. Squamous cell carcinoma developing in the scar of Fournier’s gangrene: case report. BMC Cancer 2004;4:16.
5. Laor E , Palmer LS , Tolia BM . Outcome prediction in patients with Fournier’s gangrene. J Urol 1995;154:89-92.
6. Yilmazlar T , Ozturk E , Ozguc H. Fournier’s gangrene: an analysis of 80 patients and a novel scoring system. Tech Coloproctol 2010;14:217-223.
7. Fournier JA. Gangrene foudroyante de la verge. Semin Med 1883;3:345.
8. Sorensen MD, Krieger JN, Rivara FP, Broghammer JA, Klein MB, Mack CD, Wessels H. Fournier’s Gangrene: population based epidemiology and outcomes. J Urol 2009;182:2742-2747.
9. Eke N. Fournier’s gangrene: a review of 1726 cases. Br J Surg 2000;87:718- 728
10. Benjelloun el B, Souiki T, Yakla N, Ousadden A, Mazaz K, Louchi A, Kanjaa N, Khalid A T. Fournier’s gangrene: our experience with 50 patients and analysis of factors affecting mortality. World J Emerg Surg 2013;8:13.
11. Corcoran AT, Smaldone MC, Gibbons EP, Walsh TJ, Davies BJ. Validation of the Fournier’s gangrene severity index in a large contemporary series. J Urol 2008;180:944-948.
12. Yılmazlar T, Işık Ö, Öztürk E, Özer A, Gülcü B, Ercan I. Fournier’s gangrene: review of 120 patients and predictors of mortality. Ulus Travma Acil Cerrahi Derg 2014;20:333-337.
13. Tuncel A, Keten T, Aslan Y, Kayali M, Erkan A, Koseoglu E, Atan A. Comparison of different scoring systems for outcome prediction in patients with Fournier’s gangrene:experience with 50 patients. Scand J Urol 2014;48:393- 399.
14. Roghmann F, von Bodman C, Löppenberg B, Hinkel A, Palisaar J, Noldus J. Is there a need for the Fournier’s gangrene severity index? Comparison of scoring systems for outcome prediction in patients with Fournier’s gangrene. BJU Int 2012;110:1359-1365.
15. Khandelwal R, Tandon M, Saradna,A, Gupta, D, Bahl B. Fournier’s gangrene severity index as a predictor of outcome in patients with Fournier’s gangrene: a prospective clinical study at a tertiary care center. Journal of Young Medical Researchers 2013;1:1-5.
16. Soh CR, Pietrobon R, Freiberger JJ, Chew ST, Rajgor D, Gandhi M, Shah J. Hyperbaric oxygen therapy in necrotising soft tissue infections: a study of patients in the United States Nationwide Inpatient Sample. Intensive Care Med 2012;38:1143-1151.
17. Capelli-Schellpfeffer M1, Gerber GS. The use of hyperbaric oxygen in urology. J Urol 1999;162:647-654.
18. Czymek R, Schmidt A, Eckmann C, Bouchard R, Wulff B, Laubert T, Limmer S, Bruch H P, Kujath P. Fournier’s gangrene: vacuum-assisted closure versus conventional dressings. Am J Surg 2009;197:168-176.
19. Ozturk E, Ozguc H, Yilmazlar T. The use of vacuum assisted closure therapy in the management of Fournier’s gangrene. Am J Surg 2009;197(5):660- 665; discussion 665.
20. Estrada O, Martinez I, Del Bas M, Salvans S, Hidalgo LA. Rectal diversion without colostomy in Fournier’s gangrene. Tech Coloproctol 2009;13:157- 159.
21. Lin TY, Ou CH, Tzai TS, Tong YC, Chang CC, Cheng HL, Yang W H, Lin Y M. Validation and simplification of Fournier’s gangrene severity index. Int J Urol 2014;21:696-701.
22. Erol B, Tuncel A, Hanci V, Tokgoz H, Yildiz A, Akduman B, Kargi E, Mungan A. Fournier’s gangrene: overview of prognostic factors and definition of new prognostic parameter. Urology 2010;75:1193-1198.
23. Erol B, Tuncel A, Tok A, Hanci V, Sari U, Sendogan F, Budak S, Aydemir H, Amasyali A S, Yildirim A, Caskurlu T. Low magnesium levels an important new prognostic parameter can be overlooked in patients with Fournier’sgangrene: a multicentric study.Int Urol Nephrol 2015;47:1939- 1945.

APA	YALÇINKAYA S, yildiz a, YÜKSEL M, Islamoglu E, ates n, TOKGÖZ H, savas m (2019). Can We Predict Mortality in Patients with Fournier’s Gangrene Using Questionnaires? A Pilot Study with Eighty-seven Patients. , 118 - 124. 10.4274/jus.galenos.2018.2327
Chicago	YALÇINKAYA Soner,yildiz ali,YÜKSEL MUSTAFA,Islamoglu Ekrem,ates nihat,TOKGÖZ Hüsnü,savas murat Can We Predict Mortality in Patients with Fournier’s Gangrene Using Questionnaires? A Pilot Study with Eighty-seven Patients. (2019): 118 - 124. 10.4274/jus.galenos.2018.2327
MLA	YALÇINKAYA Soner,yildiz ali,YÜKSEL MUSTAFA,Islamoglu Ekrem,ates nihat,TOKGÖZ Hüsnü,savas murat Can We Predict Mortality in Patients with Fournier’s Gangrene Using Questionnaires? A Pilot Study with Eighty-seven Patients. , 2019, ss.118 - 124. 10.4274/jus.galenos.2018.2327
AMA	YALÇINKAYA S,yildiz a,YÜKSEL M,Islamoglu E,ates n,TOKGÖZ H,savas m Can We Predict Mortality in Patients with Fournier’s Gangrene Using Questionnaires? A Pilot Study with Eighty-seven Patients. . 2019; 118 - 124. 10.4274/jus.galenos.2018.2327
Vancouver	YALÇINKAYA S,yildiz a,YÜKSEL M,Islamoglu E,ates n,TOKGÖZ H,savas m Can We Predict Mortality in Patients with Fournier’s Gangrene Using Questionnaires? A Pilot Study with Eighty-seven Patients. . 2019; 118 - 124. 10.4274/jus.galenos.2018.2327
IEEE	YALÇINKAYA S,yildiz a,YÜKSEL M,Islamoglu E,ates n,TOKGÖZ H,savas m "Can We Predict Mortality in Patients with Fournier’s Gangrene Using Questionnaires? A Pilot Study with Eighty-seven Patients." , ss.118 - 124, 2019. 10.4274/jus.galenos.2018.2327
ISNAD	YALÇINKAYA, Soner vd. "Can We Predict Mortality in Patients with Fournier’s Gangrene Using Questionnaires? A Pilot Study with Eighty-seven Patients". (2019), 118-124. https://doi.org/10.4274/jus.galenos.2018.2327

APA	YALÇINKAYA S, yildiz a, YÜKSEL M, Islamoglu E, ates n, TOKGÖZ H, savas m (2019). Can We Predict Mortality in Patients with Fournier’s Gangrene Using Questionnaires? A Pilot Study with Eighty-seven Patients. Journal of Urological Surgery, 6(2), 118 - 124. 10.4274/jus.galenos.2018.2327
Chicago	YALÇINKAYA Soner,yildiz ali,YÜKSEL MUSTAFA,Islamoglu Ekrem,ates nihat,TOKGÖZ Hüsnü,savas murat Can We Predict Mortality in Patients with Fournier’s Gangrene Using Questionnaires? A Pilot Study with Eighty-seven Patients. Journal of Urological Surgery 6, no.2 (2019): 118 - 124. 10.4274/jus.galenos.2018.2327
MLA	YALÇINKAYA Soner,yildiz ali,YÜKSEL MUSTAFA,Islamoglu Ekrem,ates nihat,TOKGÖZ Hüsnü,savas murat Can We Predict Mortality in Patients with Fournier’s Gangrene Using Questionnaires? A Pilot Study with Eighty-seven Patients. Journal of Urological Surgery, vol.6, no.2, 2019, ss.118 - 124. 10.4274/jus.galenos.2018.2327
AMA	YALÇINKAYA S,yildiz a,YÜKSEL M,Islamoglu E,ates n,TOKGÖZ H,savas m Can We Predict Mortality in Patients with Fournier’s Gangrene Using Questionnaires? A Pilot Study with Eighty-seven Patients. Journal of Urological Surgery. 2019; 6(2): 118 - 124. 10.4274/jus.galenos.2018.2327
Vancouver	YALÇINKAYA S,yildiz a,YÜKSEL M,Islamoglu E,ates n,TOKGÖZ H,savas m Can We Predict Mortality in Patients with Fournier’s Gangrene Using Questionnaires? A Pilot Study with Eighty-seven Patients. Journal of Urological Surgery. 2019; 6(2): 118 - 124. 10.4274/jus.galenos.2018.2327
IEEE	YALÇINKAYA S,yildiz a,YÜKSEL M,Islamoglu E,ates n,TOKGÖZ H,savas m "Can We Predict Mortality in Patients with Fournier’s Gangrene Using Questionnaires? A Pilot Study with Eighty-seven Patients." Journal of Urological Surgery, 6, ss.118 - 124, 2019. 10.4274/jus.galenos.2018.2327
ISNAD	YALÇINKAYA, Soner vd. "Can We Predict Mortality in Patients with Fournier’s Gangrene Using Questionnaires? A Pilot Study with Eighty-seven Patients". Journal of Urological Surgery 6/2 (2019), 118-124. https://doi.org/10.4274/jus.galenos.2018.2327