Abstract
Aim and Background
Fournier’s gangrene is an acute necrotising fasciitis affecting the perineal, perianal regions and genitalia. Cornerstones in treatment of Fournier’s gangrene are urgent necrotic tissue debridement, broad-spectrum antibiotics and resuscitation. Despite advanced management policies, mortality from Fournier’s gangrene is still high. Various scoring systems are in vogue nowadays to evaluate prognosis in such patients. We evaluated simplified prognostic scoring system to determine the risk of morbidity and mortality in such patients.
Patients and Methods
A total of 40 patients were classified according to age, body mass index, early/late detection, areas involved and comorbidities. An eight-scale simplified prognostic scoring system with maximum score of eighteen points denoting highest risk of mortality and minimum score of eight points carrying relatively lower risk of mortality was evaluated. Patient’s data was collected and analysed using Wilcoxon signed-rank test and Student’s t-test and p value <0.05 was considered statistically significant.
Results
Out of 40 patients, 5 patients (12.5%) presented with Grade I (8–10 points), 27 patients (67.5%) presented with Grade II (11–14 points) and 8 patients (20%) with Grade III (15–18 points). Patients with grade I had lesser hospital stay compared to those with grade II and III. Mortality was observed in three patients, who were late presenters with extensive disease and belonging to grade III group.
Conclusion
The present study reveals that increasing age, high BMI >30, multiple co-morbidities and late presentation with multiple area involvement are associated with high morbidity and increased mortality. Prompt early diagnosis and management may improve the morbidity and mortality of these diseases.
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Ethical Approval–Informed Consent: The authors declare that the study has been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. Also all patients gave their written informed consent prior to their inclusion to the study.
Conflict of interest: The authors declare that there is no conflict of interest.
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Bansal, A.R., Punith, M., Bansal, M. et al. Study of the Simplified Prognostic Scoring System in Patients with Fournier’s Gangrene. Hellenic J Surg 92, 18–22 (2020). https://doi.org/10.1007/s13126-020-0536-9
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DOI: https://doi.org/10.1007/s13126-020-0536-9