title: Fournier's gangrene: analysis of prognostic variables in 34 patients.
abstract: BACKGROUND
  Fournier's gangrene (FG) is the necrotizing fasciitis of the perineum and genital area. The objective of this study was to assess risk factors for mortality.
  
  
  METHODS
  We conducted an analytic and retrospective study of the patients with FG treated at our institution between 1998 and 2008. Statistical analysis was performed with the Statistical Package for Social Science for Windows, version 15.0, using the Mann-Whitney test for quantitative variables, and the chi-square and Fisher exact tests for qualitative variables, in univariate analyses.
  
  
  RESULTS
  Of the 34 patients treated, 25 survived (74%) and 9 died (26%) with a median timing of 29 days (13, 60). Statistically significant differences were not found in age, sex and predisposing factors, except heart disease (p = 0.034). Admission laboratory parameters and severity criteria showed significant differences in serum urea (p = 0.007), potassium (p = 0.008), alkaline phosphatase (p = 0.014) and Fournier's gangrene severity index score (FGSIS) (p = 0.008). Others factors such as duration of symptoms before hospital admission, extent of body surface area, number of surgical debridements, additional surgical manoeuvers (supra-pubic catheterization or colostomy), microbiological cultures and ICU stay did not show significant differences.
  
  
  CONCLUSIONS
  FG is a life-threatening necrotizing fasciitis with a high mortality rate. In our study, prognostic variables were heart disease, admission serum urea, potassium, alkaline phosphatase, and FGSIS. More studies are needed to validate these findings.
authors.affiliation: , Plaza de Gabriel Miró nº 3 1º B, 28005, Madrid, Spain. agmarin80@yahoo.es.|Emergency Department, University General Hospital "Gregorio Marañón", Madrid, Spain. agmarin80@yahoo.es.
authors.forename: A
authors.initials: A
authors.lastname: García Marín
authors.affiliation: Emergency Department, University General Hospital "Gregorio Marañón", Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Martín Gil
authors.affiliation: Emergency Department, University General Hospital "Gregorio Marañón", Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Vaquero Rodríguez
authors.affiliation: Emergency Department, University General Hospital "Gregorio Marañón", Madrid, Spain.
authors.forename: T
authors.initials: T
authors.lastname: Sánchez Rodríguez
authors.affiliation: Emergency Department, University General Hospital "Gregorio Marañón", Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: de Tomás Palacios
authors.affiliation: Emergency Department, University General Hospital "Gregorio Marañón", Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Lago Oliver
authors.affiliation: Emergency Department, University General Hospital "Gregorio Marañón", Madrid, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Turégano Fuentes
keywords: Fournier’s gangrene; Fournier’s gangrene severity index score; Necrotizing fasciitis; Surgical infection
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