p-ISSN: 1306-696x | e-ISSN: 1307-7945
Volume : 28 Issue : 8 Year : 2022

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Turkish Journal of Trauma and Emergency Surgery Risk factors for mortality in Fournier’s gangrene of anorectal origin [Ulus Travma Acil Cerrahi Derg]
Ulus Travma Acil Cerrahi Derg. 2022; 28(8): 1128-1133 | DOI: 10.14744/tjtes.2021.97866

Risk factors for mortality in Fournier’s gangrene of anorectal origin

Yasin Tosun, Ozan Akıncı, Hasan Fehmi Küçük
Department of General Surgery, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul-Türkiye

BACKGROUND: In the present study, we aimed to determine the risk factors for mortality in Fournier’s gangrene (FG), which has a high morbidity and mortality rate and requires urgent surgical intervention.
METHODS: A retrospective analysis was made of 150 patients who were operated on in our clinic due to FG of anorectal origin be-tween 2010 and 2020. The cases were divided into survival and non-survival groups. Demographic, clinical, laboratory, and treatment data, FG Severity Index (FGSI), and simplified FGSI (SFGSI) scores were analyzed.
RESULTS: Thirty-day mortality rate was 15.3%. In the non-survival group, rate of smoking, diabetes mellitus, malignancy and other chronic diseases, and mean age, duration of symptoms at admission, number of debridements, SFGSI, FGSI, white blood cells, and creatinine were significantly higher, while hematocrit, serum potassium, and albumin levels were significantly lower (p<0.05). Among these factors, age (OR=1.147, CI=1.019–1.291; p=0.023), smoking (OR=0.09, CI=0.023–0.418; p=0.002), malignancy (OR=0.038, CI=0.008–0.186; p=0.001), and serum potassium level (OR=0.141, CI=0.022–0.910; p=0.04) were identified as risk factors associated with mortality in FG.
CONCLUSION: FG is a fatal fasciitis still associated with high mortality. Advanced age, smoking, malignancy, and hypopotassemia are independent predictive risk factors for mortality in FG.

Keywords: Anorectal emergencies, Fournier’s gangrene, mortality, predictive factors.

Anorektal kaynaklı Fournier gangreninde mortaliteye etki eden risk faktörleri

Yasin Tosun, Ozan Akıncı, Hasan Fehmi Küçük
Kartal Dr. Lütfi Kırdar Şehir Hastanesi, Genel Cerrahi Kliniği, İstanbul

AMAÇ: Bu çalışmada yüksek morbidite ve mortalite ile seyreden ve acil cerrahi girişim gerektiren Fournier gangreninde mortaliteye etki eden risk faktörlerini belirlemeyi amaçladık.
GEREÇ VE YÖNTEM: 2010–2020 yılları arasında anorektal orijinli Fournier gangreni nedeniyle kliniğimizde ameliyat edilen 150 hasta geriye dönük olarak incelendi. Olgular hayatta kalan ve ölen olarak iki gruba ayrıldı. Demografik, klinik, laboratuvar, tedavi verileri ve Fournier gangreni Severity Index (FGSI), simplified FGSI (SFGSI) skorları analiz edildi.
BULGULAR: Otuz günlük mortalite oranı %15.3 idi. Ölenlerin olduğu grupta; sigara, diyabetes mellitus, malignite ve diğer kronik hastalıkların oranı; ortalama yaş, başvuruya kadar geçen süre, debridman sayısı, SFGSI, FGSI, lökosit ve kreatinin anlamlı ölçüde yüksek; hematokrit, serum potasyum ve albumin düzeyleri ise anlamlı ölçüde düşük bulunmuştur (p<0.05). Bu faktörlerden yaş (OR=1.147, CI=1.019–1.291; p=0.023), sigara (OR=0.09, CI=0.023–0.418; p=0.002), malignite (OR=0.038, CI=0.008–0.186; p=0.001) ve serum potasyum düzeyi (OR=0.141, CI=0.022–0.910; p=0.04) Fournier gangreninde mortalite ile ilişkili risk faktörleri olarak tespit edilmiştir.
TARTIŞMA: Fournier gangreni halen yüksek mortalite ile seyreden fatal bir fasiittir. İleri yaş, sigara, malignite ve hipopotasemi Fournier gangreninde mortalite için bağımsız prediktif risk faktörlerdir.

Anahtar Kelimeler: Anorektal aciller, Fournier gangreni, mortalite, prediktif faktörler.

Yasin Tosun, Ozan Akıncı, Hasan Fehmi Küçük. Risk factors for mortality in Fournier’s gangrene of anorectal origin. Ulus Travma Acil Cerrahi Derg. 2022; 28(8): 1128-1133

Corresponding Author: Ozan Akıncı, Türkiye
Manuscript Language: English