Ulus Travma Acil Cerrahi Derg. Baskýdaki Makaleler: UTD-63576

Fournier Gangreni Hastalarýnda Acil Cerrahide Mortaliteyi Öngörmede qSOFA Skorunun Kullanýlabilirliði

Adem Sancý, Hüseyin Mert Durak, Berk Yasin Ekenci, Ahmet Emin Doðan, Metin Yýðman, Kubilay Sarýkaya, Levent Saðnak, Ahmet Nihat Karakoyunlu
Etlik Þehir Hastanesi, Üroloji, Ankara, Türkiye

Amaç
Bu çalýþmanýn amacý, Fournier gangreni hastalarýnda qSOFA skorunun mortalite riskini tahmin etmedeki deðerini deðerlendirmek ve erken klinik karar verme sürecine yardýmcý olacak basit bir araç sunmaktýr.
Yöntemler
Bu retrospektif çalýþmaya, 2022 ile 2024 yýllarý arasýnda Fournier gangreni nedeniyle acil debridman uygulanan hastalar dahil edilmiþtir. Perianal ve inguinal kanalýn sistemik tutulumu olan hastalar çalýþmaya alýnmýþtýr. Klinik parametreler, laboratuvar belirteçleri, FGSI skorlarý ve mortalite ile hastanede kalýþ süresi gibi sonuçlar analiz edilmiþtir. Hastalar qSOFA skoruna göre iki gruba ayrýlmýþtýr: Grup 1 (qSOFA 0–1) ve Grup 2 (qSOFA ≥2). Mortaliteyi etkileyen baðýmsýz deðiþkenleri belirlemek amacýyla univaryant ve multivaryant lojistik regresyon analizleri yapýlmýþtýr.
Bulgular
Toplam 89 hastanýn 55’i Grup 1’de, 34’ü Grup 2’de yer almýþtýr. Genel mortalite oraný %21,35 olarak bulunmuþtur (Grup 1: %12,73; Grup 2: %35,29; p < 0,05). Yaþ, komorbiditeler, solunum hýzý, prokalsitonin düzeyleri, FGSI skorlarý ve hastanede kalýþ süresi açýsýndan gruplar arasýnda anlamlý farklar saptanmýþtýr (p < 0,05). Univaryant analizde yaþ, FGSI skoru, komorbiditeler ve prokalsitonin mortalite ile iliþkili bulunmuþtur. qSOFA skoru ≥2 olan hastalarda mortalite oraný anlamlý þekilde daha yüksek olup (p < 0,05), multivaryant analizde bu skor baðýmsýz bir mortalite belirleyicisi olarak saptanmýþtýr (OR: 3,00; p < 0,05).
Sonuç
qSOFA skoru, Fournier gangreni hastalarýnda mortaliteyi öngörmede basit ve güvenilir bir göstergedir. Bu nedenle erken risk deðerlendirmesi ve zamanýnda klinik müdahalelerin yönlendirilmesinde kullanýlabilir.

Anahtar Kelimeler: Fournier Gangreni, qSOFA Skoru, Mortalite Tahmini, Sepsis, Prognostik Araç

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The Utility of qSOFA Score in Predicting Mortality in Fournier’s Gangrene Patients in Emergency Surgery

Adem Sancý, Hüseyin Mert Durak, Berk Yasin Ekenci, Ahmet Emin Doðan, Metin Yýðman, Kubilay Sarýkaya, Levent Saðnak, Ahmet Nihat Karakoyunlu
Etli̇k Cýty Hospýtal, Urology, Ankara, Turkey

Objectives
This study aimed to evaluate the predictive value of the qSOFA score in estimating mortality risk in Fournier’s gangrene patients and to provide a simple tool for early clinical decision-making.
Methods
This retrospective study included patients who underwent emergency debridement for Fournier’s gangrene between 2022 and 2024. Patients with systemic involvement of the perianal and inguinal canal were included. Clinical parameters, laboratory markers, FGSI scores, and outcomes such as mortality and hospital stay were analyzed. Patients were categorized into two groups: Group 1 (qSOFA 0-1) and Group 2 (qSOFA ≥2). Univariate and multivariate logistic regression analyses were performed to identify independent mortality predictors.
Results
Among 89 patients, 55 were in Group 1 and 34 in Group 2. The overall mortality rate was 21.35% (Group 1: 12.73%, Group 2: 35.29%, p < 0.05). Significant differences were observed between groups in age, comorbidities, respiratory rate, procalcitonin, FGSI scores, and hospital stay (all p < 0.05). Univariate analysis identified age, FGSI score, comorbidities, and procalcitonin as mortality-related factors. A qSOFA score ≥2 was significantly associated with higher mortality (p < 0.05), and multivariate analysis confirmed it as an independent predictor (OR 3.00, p < 0.05).
Conclusions
The qSOFA score is a simple and reliable predictor of mortality in Fournier’s gangrene, supporting its use for early risk assessment and guiding timely clinical interventions.

Keywords: Fournier's Gangrene, qSOFA Score, Mortality Prediction, Sepsis, Prognostic Tool

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