Fournier gangreni:  18 olgudaki prognoza etki eden risk fakt�rlerinin ve tedavi maliyetinin de�erlendirilmesi

Canbaz, Hakan; �a�l�k�lek�i, Mehmet; Altun, U�ur; Dirlik, Musa; T�rkmeno�lu, �zg�r; Ta�delen, Bahar; Ayd�n, S�ha

Cilt : 16 Say� : 1 Y�l : 2024

30/12Gelecek Say� Ar�iv Kapaklar Pop�ler Makaleler

ICMJE COI Form

H�zl� Arama

Fournier gangreni: 18 olgudaki prognoza etki eden risk fakt�rlerinin ve tedavi maliyetinin de�erlendirilmesi [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. 2010; 16(1): 71-76

Fournier gangreni: 18 olgudaki prognoza etki eden risk fakt�rlerinin ve tedavi maliyetinin de�erlendirilmesi

Hakan Canbaz¹, Mehmet �a�l�k�lek�i¹, U�ur Altun¹, Musa Dirlik¹, �zg�r T�rkmeno�lu¹, Bahar Ta�delen², S�ha Ayd�n¹
¹Mersin �niversitesi T�p Fak�ltesi, Genel Cerrahi Ana Bilim Dal�, Mersin.
²Mersin �niversitesi T�p Fak�ltesi, Biyoistatistik Ana Bilim Dal�, Mersin.

AMA�
Fournier gangreni (FG) h�zl� ilerleyen sinerjistik, polimikrobiyal nekrotizan fasiittir. Hastal��n mortalitesi halen y�ksektir. �al��mam�zda hastalar�n prognozuna etki eden risk fakt�rlerini ve tedavi maliyetini belirlemeyi ama�lad�k.
GERE� VE Y�NTEM
2003-2007 y�llar� aras�nda FG nedeniyle ameliyat edilen 18 hastan�n dosyalar� retrospektif olarak incelendi. Ya�ayan ve �l�mc�l seyreden hasta gruplar� demografik �zellikler, etyolojik fakt�rler, laboratuvar bulgular� ve tedavi uygulamalar� yan� s�ra hastanede kal�� s�resi ve tedavi giderleri y�n�nden kar��la�t�r�ld�.

BULGULAR
Hastalar�n ya� ortalamas� 54,5 ve kad�n/erkek oran� 6/12 idi. Mortalite 6 (%33,3) hastada g�zlendi ve kad�nlarda (%66,6) anlaml� �ekilde fazlayd� (p=0,035). �ik�yet s�resi �l�mc�l seyreden hastalarda (9�3 g�n) ya�ayanlardan (5�3 g�n) fazlayd� (p=0,018). En s�k; yanda� hastal�k diyabet (%39,2), etyoloji perianal apse (%55,6), enfeksiyonun primer yerle�imi anorektal b�lgeydi (%61,1). Hiponatremi ya�ayan hastalarda fazlayd� (p=0,039). FG �iddet puan� ortalamas� �l�mc�l seyredenlerde (6,83) ya�ayanlardan (3.17) fazlayd� (p=0,011). Hastalarda en s�k �reyen bakteri E.coli�ydi (%66,6) ve mortal seyreden hastalarda anlaml� �ekilde fazlayd� (p=0,012). Hastalar�n debridman say�s� ortalamas� 4,67 idi. Fekal diversiyon 7 (%38,8) hastaya uygulanm��t�. Hastanede yat�� s�resi ya�ayanlarda (34,17 g�n) �l�mc�l (10,50 g�n) olanlardan fazlayd� (p=0,002). Hasta gruplar�n�n tedavi maliyeti farks�zd� (p>0,05).
SONU�
Kad�n cinsiyeti, tedavi �ncesi ge�en �ik�yetin s�resi, FG �iddet puan� ve k�lt�rde �reyen mikroorganizman�n (E. coli) mortaliteyi etkileyebilece�i d��n�lmektedir. FG tedavi s�resi uzun ve maliyeti fazla olabilecek bir hastal�kt�r.

Anahtar Kelimeler: Enfeksiyon, Fournier gangreni; nekrotizan fasiit; mortalite; prognoz; tedavi maliyeti.

Fournier�s gangrene: analysis of risk factors affecting the prognosis and cost of therapy in 18 cases

Hakan Canbaz¹, Mehmet �a�l�k�lek�i¹, U�ur Altun¹, Musa Dirlik¹, �zg�r T�rkmeno�lu¹, Bahar Ta�delen², S�ha Ayd�n¹
¹Department Of General Surgery, Mersin University, Mersin, Turkey.
²Department Of Biostatistics, Mersin University, Mersin, Turkey.

BACKGROUND
Fournier�s gangrene (FG) is a rapidly progressive, polymicrobial, synergistic necrotizing fasciitis, and the mortality rate is still high. We aimed to determine the risk factors affecting prognosis and treatment cost.
METHODS
Eighteen patients operated for FG during 2003-2007 were investigated retrospectively. Surviving and exitus groups were compared regarding demographic data, etiological factors, laboratory findings, treatment modality, length of hospital stay, and treatment cost.
RESULTS
Mean age was 54.5 years, and the female/male ratio was 6/12. Mortality was observed in 6 (33.3%) patients and was significantly high among females (66.6%) (p=0.035). Mean duration of complaint in the exitus group (9�3 days) was higher than in survivors (5�3 days) (p=0.018). The most frequent comorbid disease was diabetes (39.2%), the most frequent etiology was perianal abscess (55.6%) and the primary location of infection was anorectal region (61.1%). Hyponatremia was significantly high in surviving patients (p=0.039). Mean of FG severity point in the exitus group (6.83) was higher than in survivors (3.17) (p=0.011). The most frequently cultivated microorganism, Escherichia coli (66.6%), was significantly high in the exitus group (p=0.012). The mean number of debridements was 4.67. Fecal diversion was performed in 7 (38.8%) patients. Hospital stay in the surviving group (34.17 days) was higher than in the exitus group (10.50 days) (p=0.002). Treatment cost between groups was indifferent (p>0.05).
CONCLUSION
Female gender, duration of complaint, FG severity point, and cultivated microorganism (E. coli) were thought to affect mortality. FG is a disease that might cause extended hospital stay and high treatment cost.

Keywords: Infection, Fournier gangrene; necrotizing fasciitis; mortality; prognosis; treatment cost.

Sorumlu Yazar: Hakan Canbaz, T�rkiye
Makale Dili: T�rk�e

ATIF KOPYALA

Tam Metin PDF At�f dosyas� indir RIS EndNote BibTex Medlars Procite Reference Manager Yazara e-posta g�nder Benzer makaleler PubMed Google Scholar