title: Predictive factors for mortality in Fournier' gangrene: a series of 59 cases.
abstract: OBJECTIVE
  Fournier's gangrene (FG) is the necrotizing fasciitis of the perineum and genital area and presents a high mortality rate. The aim was to assess prognostic factors for mortality, create a new mortality predictive scale and compare it with previously published scales in patients diagnosed with FG in our Emergency Department.
  
  
  METHODS
  Retrospective analysis study between 1998 and 2012.
  
  
  RESULTS
  Of the 59 patients, 44 survived (74%) (S) and 15 died (26%) (D). Significant differences were found in peripheral vasculopathy (S 5 [11%]; D 6 [40%]; P=.023), hemoglobin (S 13; D 11; P=.014), hematocrit (S 37; D 31.4; P=.009), white blood cells (S 17,400; D 23,800; P=.023), serum urea (S 58; D 102; P<.001), creatinine (S 1.1; D 1.9; P=.032), potassium (S 3.7; D 4.4; P=.012) and alkaline phosphatase (S 92; D 133; P=.014). Predictive scores: Charlson index (S 1; D 4; P=.013), severe sepsis criteria (S 16 [36%]; D 13 [86%]; P=.001), Fournier's gangrene severity index score (FGSIS) (S 4; D 7; P=.002) and Uludag Fournier's Gangrene Severity Index (UFGSI) (S 9; D 13; P=.004). Independent predictive factors were peripheral vasculopathy, serum potassium and severe sepsis criteria, and a model was created with an area under the ROC curve of 0.850 (0.760-0.973), higher than FGSIS (0.746 [0.601-0.981]) and UFGSI (0.760 [0.617-0.904]).
  
  
  CONCLUSIONS
  FG showed a high mortality rate. Independent predictive factors were peripheral vasculopathy, potassium and severe sepsis criteria creating a predictive model that performed better than those previously described.
authors.affiliation: Servicio de Cirugía de Urgencias, Hospital Universitario San Juan, Alicante, España; Departamento de Patología y Cirugía, Universidad Miguel Hernández, Elche, España. Electronic address: agmarin1980@gmail.com.
authors.forename: Andrés
authors.initials: A
authors.lastname: García Marín
authors.affiliation: Sección Cirugía de Urgencias, Servicio de Cirugía General 2, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: Fernando
authors.initials: F
authors.lastname: Turégano Fuentes
authors.affiliation: Sección Cirugía de Urgencias, Servicio de Cirugía General 2, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: Marta
authors.initials: M
authors.lastname: Cuadrado Ayuso
authors.affiliation: Servicio de Urgencias, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: Andueza Lillo
authors.affiliation: Servicio de Urgencias, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Cano Ballesteros
authors.affiliation: Facultad de Enfermería, Universidad de Alicante, Alicante, España.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Pérez López
mesh_terms: D000368:Aged; D005260:Female; D018934:Fournier Gangrene / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies
keywords: Factores predictores; Fascitis necrosante; Fournier's gangrene; Gangrena de Fournier; Mortalidad; Mortality; Necrotizing fasciitis; Predictive factors