Low magnesium levels an important new prognostic parameter can be overlooked in patients with Fournier's gangrene: a multicentric study.
BACKGROUND
We evaluated low magnesium levels and three different scoring systems including the Fournier's Gangrene Severity Index (FGSI), the Uludag Fournier's Gangrene Severity Index (UFGSI), and the Charlson Comorbidity Index (CCI) for predicting mortality in a multicentric, large patient population with FG.


METHODS
The medical records of 99 FG patients who were treated and followed up in different clinics were reviewed. The biochemical, hematological, and bacteriological results from the admission evaluation were recorded. The CCI, FGSI, and UFGSI were evaluated and stratified by survival.


RESULTS
The results were evaluated for the following patients: the survivors (n = 82) and the nonsurvivors (n = 17). The magnesium level for the survivors and nonsurvivors was 2.09 ± 0.28 and 1.68 ± 0.23, respectively (p 0.004). The admission FGSI, UFGSI, and CCI scores were significantly higher in nonsurvivors (p 0.001, p 0.001, p < 0.001, respectively). The receiver operating characteristics analysis revealed that the UFGSI was more powerful than the FGSI. The hypomagnesemia, low hemoglobin and hematocrit, low albumin and HCO3 levels; high alkaline phosphatase; and the high heart and respiratory rates, an FGSI >9, rectal involvement, and a high CCI were associated with a worse prognosis.


CONCLUSIONS
Low magnesium levels might be an important parameter for a worse FG prognosis. Monitoring the serum magnesium levels might have prognostic and therapeutic implications in patients with FG. High CCI, FGSI, and UFGSI scores might be associated with a worse prognosis in patients with FG. The UFGSI might be more powerful scoring system than the FGSI.
Department of Urology, Istanbul Medeniyet University Faculty of Medicine, Dr. Erkin Cad. Istanbul Medeniyet Universitesi Goztepe Eğitim Arastirma Hastanesi, Kadikoy/Istanbul, Turkey. erolbulent@yahoo.com.
Bulent
B
Erol
Department of Urology, Ankara Numune Training and Research Hospital, Ankara, Turkey.
Altug
A
Tuncel
Department of Urology, Bulent Ecevit University Faculty of Medicine, Zonguldak, Turkey.
Adem
A
Tok
Department of Anesthesiology, Dokuz eylul University Faculty of Medicine, Izmir, Turkey.
Volkan
V
Hanci
Department of Urology, Istanbul Medeniyet University Faculty of Medicine, Dr. Erkin Cad. Istanbul Medeniyet Universitesi Goztepe Eğitim Arastirma Hastanesi, Kadikoy/Istanbul, Turkey.
Utku
U
Sari
Department of Urology, Istanbul Medeniyet University Faculty of Medicine, Dr. Erkin Cad. Istanbul Medeniyet Universitesi Goztepe Eğitim Arastirma Hastanesi, Kadikoy/Istanbul, Turkey.
Furkan
F
Sendogan
Department of Urology, Izmir Tepecik Training and Research Hospital, Izmir, Turkey.
Salih
S
Budak
Department of Urology, Sakarya Training and Research Hospital, Sakarya, Turkey.
Huseyin
H
Aydemir
Department of Urology, Adnan Menderes University, Faculty of Medicine, Aydin, Turkey.
Akin Soner
AS
Amasyali
Department of Urology, Istanbul Medeniyet University Faculty of Medicine, Dr. Erkin Cad. Istanbul Medeniyet Universitesi Goztepe Eğitim Arastirma Hastanesi, Kadikoy/Istanbul, Turkey.
Asif
A
Yildirim
Department of Urology, Istanbul Medeniyet University Faculty of Medicine, Dr. Erkin Cad. Istanbul Medeniyet Universitesi Goztepe Eğitim Arastirma Hastanesi, Kadikoy/Istanbul, Turkey.
Turhan
T
Caskurlu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D018934:Fournier Gangrene / Q000097:blood* / Q000401:mortality* / Q000628:therapy; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000453:epidemiology; D008274:Magnesium / Q000097:blood*; D008297:Male; D052801:Male Urogenital Diseases / Q000097:blood* / Q000401:mortality* / Q000628:therapy; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012611:Scrotum; D012720:Severity of Illness Index
D015415:Biomarkers; D008274:Magnesium
Fournier’s Gangrene; Index; Magnesium; Prognosis