title: Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratios Are More Effective than the Fournier's Gangrene Severity Index for Predicting Poor Prognosis in Fournier's Gangrene.
abstract: BACKGROUND
  We investigated the value of the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) as markers of mortality in patients with Fournier's gangrene.
  
  
  METHODS
  Records from 62 patients treated for Fournier's gangrene between 2003 and 2014 were reviewed retrospectively. Data were collected regarding medical history, symptoms, physical examination findings, admission laboratory tests, and the extent of body surface area involved (%). Fournier's Gangrene Severity Index score, NLR, and PLR were calculated. The data were assessed separately for surviving and deceased patients.
  
  
  RESULTS
  Of the 62 patients, 36 survived (58%, group 1) and 26 died (42%, group 2). Parameters that were statistically different between the two groups (p < 0.05) were the NLR, PLR, Fournier's Gangrene Severity Index score, and admission laboratory parameters, including body temperature, heart rate, bicarbonate, albumin, and serum calcium. The average body surface area affected in group 2 was statistically different from that of group 1 (6.0% versus 2.3%, p = 0.001). A high Fournier's Gangrene Severity Index score (>9), high NLR (>8), and high PLR (>140) were associated more frequently with group 2 patients. Multivariable regression analysis showed that high NLR (adjusted odds ratio [OR], 4.66; 95% confidence interval [CI], 1.25-17.3; p = 0.022) and high PLR (adjusted OR, 11.6; 95% CI, 2.7-49.5; p = 0.001) were independent prognostic factors for poor prognosis from Fournier's gangrene. However, the Fournier's Gangrene Severity Index score did not shown any statistically significant effect on mortality (p = 0.086).
  
  
  CONCLUSIONS
  The Fournier's Gangrene Severity Index scoring system was not associated with determining poor prognosis, however, high NLR and high PLR were associated with predictors of mortality in patients with Fournier's gangrene.
authors.affiliation: Department of Urology, Chonnam National University Medical School , Gwangju, Korea.
authors.forename: Sang Un
authors.initials: SU
authors.lastname: Yim
authors.affiliation: Department of Urology, Chonnam National University Medical School , Gwangju, Korea.
authors.forename: Sun Woo
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Urology, Chonnam National University Medical School , Gwangju, Korea.
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Ahn
authors.affiliation: Department of Urology, Chonnam National University Medical School , Gwangju, Korea.
authors.forename: Yang Hyun
authors.initials: YH
authors.lastname: Cho
authors.affiliation: Department of Urology, Chonnam National University Medical School , Gwangju, Korea.
authors.forename: Hoseok
authors.initials: H
authors.lastname: Chung
authors.affiliation: Department of Urology, Chonnam National University Medical School , Gwangju, Korea.
authors.forename: Eu Chang
authors.initials: EC
authors.lastname: Hwang
authors.affiliation: Department of Urology, Chonnam National University Medical School , Gwangju, Korea.
authors.forename: Ho Song
authors.initials: HS
authors.lastname: Yu
authors.affiliation: Department of Urology, Chonnam National University Medical School , Gwangju, Korea.
authors.forename: Kyung Jin
authors.initials: KJ
authors.lastname: Oh
authors.affiliation: Department of Urology, Chonnam National University Medical School , Gwangju, Korea.
authors.forename: Sun-Ouck
authors.initials: SO
authors.lastname: Kim
authors.affiliation: Department of Urology, Chonnam National University Medical School , Gwangju, Korea.
authors.forename: Seung Il
authors.initials: SI
authors.lastname: Jung
authors.affiliation: Department of Urology, Chonnam National University Medical School , Gwangju, Korea.
authors.forename: Taek Won
authors.initials: TW
authors.lastname: Kang
authors.affiliation: Department of Urology, Chonnam National University Medical School , Gwangju, Korea.
authors.forename: Dong Deuk
authors.initials: DD
authors.lastname: Kwon
authors.affiliation: Department of Urology, Chonnam National University Medical School , Gwangju, Korea.
authors.forename: Kwangsung
authors.initials: K
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001792:Blood Platelets; D005260:Female; D018934:Fournier Gangrene / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D010976:Platelet Count; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis