[Fournier's gangrene: analysis of risk factors affecting the prognosis and cost of therapy in 18 cases].
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.
Canbaz
Hakan
H
Department of General Surgery, Mersin University, Faculty of Medicine, Mersin, Turkey. canbazhakan@yahoo.com
Cağlikülekçi
Mehmet
M
Altun
Uğur
U
Dirlik
Musa
M
Türkmenoğlu
Ozgür
O
Taşdelen
Bahar
B
Aydin
Süha
S
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
D000900:Anti-Bacterial Agents