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2017 ; 16
(ä): 19-22
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Case series of Fournier s gangrene: Affected body surface area - The
underestimated prognostic factor
#MMPMID28289541
Morais H
; Neves J
; Maciel Ribeiro H
; Ferreira M
; Guimarães N
; Azenha N
; Dias R
; Fonseca A
; Conceição L
Ann Med Surg (Lond)
2017[Apr]; 16
(ä): 19-22
PMID28289541
show ga
OBJECTIVES: Identifying the factors affecting the outcome of patients with
Fournier's Gangrene and assaying the accuracy of the Fournier Gangrene Severity
Index (FGIS), the Uludag score (UdS), affected Body Surface Area (BSA) and the
Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) model as prognostic
tools. MATERIALS AND METHODS: Retrospective study involving all patients with
Fournier's gangrene treated in our Hospital between January 2008 and December
2015. The epidemiological, clinical, biochemical and management data of these
patients was obtained and analyzed. RESULTS: The series includes 19 patients, 14
male and 5 female, with a median age of 70 (62; 78,5) years. The mortality rate
was 21%. From the data analyzed, only the affected BSA (BSA>3.25%) was associated
with mortality (p = 0.016). None of the established scores (FGSI; UdS; LRINEC)
proved to be a useful tool for predicting mortality. The combination of affected
BSA and FSGI (FGSI?9 or BSA>3.25%), (p = 0.004) and the combination of the
affected BSA and the LRINEC model (LRICEC?8 and BSA>3.25%), (p = 0.004) led to a
major improvement in these scores. CONCLUSIONS: Affected BSA is a useful
prognostic factor in Fournier's gangrene. The existing prognostic scores can be
improved with the introduction of this factor.