title: Fournier's gangrene: etiology and outcome analysis of 41 patients.
abstract: BACKGROUND
  Fournier's gangrene (FG) is the necrotizing fasciitis of the perineum and genital area with high mortality.
  
  
  METHODS
  A retrospective review included 41 patients diagnosed with FG in our hospitals from 1995 to 2010, divided into survivors and nonsurvivors. We analyzed anamnestic, clinical and laboratory data.
  
  
  RESULTS
  The mortality rate was 36.6% (15/41 patients). Elevated heart and respiratory rates, high serum creatinine, low serum bicarbonate, pre-existing kidney disease, and higher median extent of affected body surface were associated with higher mortality. Severe sepsis on admission and hypotension below 90 mm Hg were also predictive for higher mortality. The median FG severity index (FGSI) score was higher in nonsurvivors (11 compared to 6, p < 0.0001). No cases of testicular necrosis were noted.
  
  
  CONCLUSIONS
  Besides standard clinical and laboratory parameters included in the FGSI calculation, higher extent of affected body surface area and presence of hypotension on admission were also positively associated with mortality.
authors.affiliation: Department of Surgery and Urology, Zabok General Hospital, Zabok, Croatia.
authors.forename: Silvio
authors.initials: S
authors.lastname: Altarac
authors.forename: Davorin
authors.initials: D
authors.lastname: Katušin
authors.forename: Suad
authors.initials: S
authors.lastname: Crnica
authors.forename: Dino
authors.initials: D
authors.lastname: Papeš
authors.forename: Zoran
authors.initials: Z
authors.lastname: Rajković
authors.forename: Nuhi
authors.initials: N
authors.lastname: Arslani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D017523:Croatia; D005260:Female; D018934:Fournier Gangrene / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D017524:Slovenia; D013997:Time Factors; D016896:Treatment Outcome