Anorektal kaynaklý Fournier gangreninde mortaliteye etki eden risk faktörleri

AMAÇ: Bu çalýþmada yüksek morbidite ve mortalite ile seyreden ve acil cerrahi giriþim gerektiren Fournier gangreninde mortaliteye etki eden risk faktörlerini belirlemeyi amaçladýk.
GEREÇ VE YÖNTEM: 2010–2020 yýllarý arasýnda anorektal orijinli Fournier gangreni nedeniyle kliniðimizde ameliyat edilen 150 hasta geriye dönük olarak incelendi. Olgular hayatta kalan ve ölen olarak iki gruba ayrýldý. Demografik, klinik, laboratuvar, tedavi verileri ve Fournier gangreni Severity Index (FGSI), simplified FGSI (SFGSI) skorlarý analiz edildi.
BULGULAR: Otuz günlük mortalite oraný %15.3 idi. Ölenlerin olduðu grupta; sigara, diyabetes mellitus, malignite ve diðer kronik hastalýklarýn oraný; ortalama yaþ, baþvuruya kadar geçen süre, debridman sayýsý, SFGSI, FGSI, lökosit ve kreatinin anlamlý ölçüde yüksek; hematokrit, serum potasyum ve albumin düzeyleri ise anlamlý ölçüde düþük bulunmuþtur (p<0.05). Bu faktörlerden yaþ (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 iliþkili risk faktörleri olarak tespit edilmiþtir.
TARTIÞMA: Fournier gangreni halen yüksek mortalite ile seyreden fatal bir fasiittir. Ýleri yaþ, sigara, malignite ve hipopotasemi Fournier gangreninde mortalite için baðýmsýz prediktif risk faktörlerdir.

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

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.