title: Fournier gangrene: description of 37 cases and analysis of associated health care costs.
abstract: OBJECTIVE
  Fournier gangrene is a urological emergency associated with a high mortality. It is a necrotizing fasciitis caused by polymicrobial infection originating in the anorectal or genitourinary area. The aim of this study was to analyze the epidemiological and clinical characteristics of Fournier gangrene along with the variables that influence disease course and mortality in patients treated in our department.
  
  
  METHODS
  We carried out a retrospective study of 37 patients diagnosed with Fournier gangrene between January 2001 and October 2010.
  
  
  RESULTS
  All the patients were men, 43.2% had diabetes, and the mean age of the patients was 57.68 years. Statistically significant differences were observed between the age of surviving patients and that of patients who died (55.8 and 69.6 years, respectively). The mean hospital stay was 27.54 days and 32.4% of patients required admission to the intensive care unit. Etiology was unknown in 39.8% of cases. Polymicrobial infection was observed in 59.5% of cases. The mean health care cost associated with a patient diagnosed with Fournier gangrene admitted to intensive care and requiring at least 1 procedure in the operating room was €25,108.67. Mortality was 13.5%. Based on analysis of individual comorbid conditions, only ischemic heart disease displayed a statistically significant association with mortality due to Fournier gangrene; ischemic heart disease was also associated with longer hospital stay.
  
  
  CONCLUSIONS
  Fournier gangrene is associated with high mortality despite appropriate early treatment. Although the condition is infrequent, the high associated health care costs suggest that primary and secondary prevention measures should be implemented.
authors.affiliation: Servicio de Urología, Hospital Universitario San Cecilio, Granada, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Jiménez-Pacheco
authors.forename: M Á
authors.initials: MÁ
authors.lastname: Arrabal-Polo
authors.forename: S
authors.initials: S
authors.lastname: Arias-Santiago
authors.forename: M
authors.initials: M
authors.lastname: Arrabal-Martín
authors.forename: M
authors.initials: M
authors.lastname: Nogueras-Ocaña
authors.forename: A
authors.initials: A
authors.lastname: Zuluaga-Gómez
mesh_terms: D000368:Aged; D000437:Alcoholism / Q000453:epidemiology; D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use; D003131:Combined Modality Therapy; D015897:Comorbidity; D003646:Debridement / Q000191:economics / Q000706:statistics & numerical data; D048909:Diabetes Complications / Q000191:economics / Q000453:epidemiology; D004630:Emergencies; D018934:Fournier Gangrene / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology; D019651:Plastic Surgery Procedures / Q000191:economics / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents