title: Are neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as effective as Fournier's gangrene severity index for predicting the number of debridements in Fourner's gangrene?
abstract: BACKGROUND
  Fournier's gangrene (FG) is a rapidly progressive and necrotizing infection of the subcutaneous and fascial tissues with a high mortality rate. In the present study, we aimed to investigate prognostic factors and analyze the outcomes of 68 patients in a tertiary reference hospital.
  
  
  METHODS
  Patients admitted to the emergency department were investigated retrospectively between January 2006 and January 2013 and divided into two groups. The patients in Group I (G1) required one debridement, and Group II (G2) patients required more than one. Patient demographic and clinical characteristics were encoded. Fournier's Gangrene Severity Index (FGSI) scores, neutrophil-lymphocyte ratios (NLR), and platelet-lymphocyte ratios (PLR) were calculated. Prognostic factors were compared between the groups.
  
  
  RESULTS
  There were no statistically significant differences between the groups in terms of mean age, female-male ratio, or duration of symptoms on admission; however, there were more infection sources, predisposal factors, and positive culture results in G2. Additionally, hospital stay, total cost, and mortality rate values were high in G2. We found statistically higher NLR and PLR ratios in G2, but there was no significant difference in FGSI scores between the groups.
  
  
  CONCLUSIONS
  The FGSI scoring system was not found to be valuable in determining prognosis. However, NLR and PLR were valuable, and previous use of NLR and PLR for determining Fournier's gangrene prognosis could not be found in the English literature.
authors.affiliation: Department of General Surgery, Kars State Hospital Ministry of Health, Kars, Turkey. drkahramancasahin@gmail.com.
authors.forename: Sahin
authors.initials: S
authors.lastname: Kahramanca
authors.affiliation: Department of General Surgery, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
authors.forename: Oskay
authors.initials: O
authors.lastname: Kaya
authors.affiliation: Department of General Surgery, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
authors.forename: Gülay
authors.initials: G
authors.lastname: Özgehan
authors.affiliation: Department of General Surgery, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Irem
authors.affiliation: Department of General Surgery, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Dural
authors.affiliation: Department of General Surgery, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
authors.forename: Tevfik
authors.initials: T
authors.lastname: Küçükpınar
authors.affiliation: Department of General Surgery, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
authors.forename: Hülagü
authors.initials: H
authors.lastname: Kargıcı
mesh_terms: D000328:Adult; D000368:Aged; D003646:Debridement / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital; D005260:Female; D018934:Fournier Gangrene / Q000473:pathology / Q000601:surgery*; D005734:Gangrene / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008214:Lymphocytes / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000502:physiology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index