title: [Fournier's gangrene: analysis of risk factors affecting the prognosis and cost of therapy in 18 cases].
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of General Surgery, Mersin University, Faculty of Medicine, Mersin, Turkey. canbazhakan@yahoo.com
authors.forename: Hakan
authors.initials: H
authors.lastname: Canbaz
authors.forename: Mehmet
authors.initials: M
authors.lastname: Cağlikülekçi
authors.forename: Uğur
authors.initials: U
authors.lastname: Altun
authors.forename: Musa
authors.initials: M
authors.lastname: Dirlik
authors.forename: Ozgür
authors.initials: O
authors.lastname: Türkmenoğlu
authors.forename: Bahar
authors.initials: B
authors.lastname: Taşdelen
authors.forename: Süha
authors.initials: S
authors.lastname: Aydin
mesh_terms: D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use; D015897:Comorbidity; D003362:Cost-Benefit Analysis; D003646:Debridement / Q000191:economics / Q000379:methods; D004927:Escherichia coli Infections / Q000401:mortality / Q000473:pathology / Q000601:surgery; D005260:Female; D018934:Fournier Gangrene / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents