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- Title
Prognostic Aspects, Survival Rate, and Predisposing Risk Factors in Patients with Fournier's Gangrene and Necrotizing Soft Tissue Infections: Evaluation of Clinical Outcome of 55 Patients.
- Authors
Martinschek, A.; Evers, B.; Lampl, L.; Gerngroß, H.; Schmidt, R.; Sparwasser, C.
- Abstract
Objective: To determine predisposing or prognostic factors and mortality rates of patients with Fournier's gangrene compared to other necrotizing soft tissue infections (NSTI). Material and Methods: Data of 55 intensive care patients (1981-2010) with NSTI were evaluated. Data were collected prospectively. Results: 43.4% of the patients were in septic condition and 27.3% were hemodynamically unstable. Half of the patients showed predisposing factors (52.7%). The lower extremity (63.2%), abdomen (30.9%), and perineum (14.5%) were most affected. Polymicrobial infections were frequent (65.5%, mean 2.8, range: 1-4). The mortality rate was 16.4% (n = 9). An increase was shown for diabetes mellitus (20%), cardiac insufficiency (22.3%), septic condition at presentation (33.3%), abdominal affection (47.1%), and hemodynamic instability (46.7%). Comparing survivors and nonsurvivors, statistical significance was seen with age (p < 0.001), septic condition at admission (p < 0.001), hemodynamic instability (p < 0.001), low blood pressure (p < 0.001), and abdominal affection (p < 0.001). In laboratory findings, an increase of creatine kinase (p < 0.001) and lactate (p < 0.001) and a decrease of antithrombin III (p < 0.007) and the Quick value (p < 0.01) proved to be significant. Conclusion: Patients with Fournier's gangrene do not differ in all aspects from those with other NSTI. Successful treatment consists of immediate surgical debridement, broad-spectrum antibiotic treatment, and critical care management. Supportive hyperbaric oxygen therapy should be considered. Copyright © 2012 S. Karger AG, Basel
- Subjects
FOURNIER gangrene; SOFT tissue infections; MORTALITY; CRITICAL care medicine; HYPERBARIC oxygenation; HEALTH outcome assessment; MEDICAL statistics; PROGNOSIS
- Publication
Urologia Internationalis, 2012, Vol 89, Issue 2, p173
- ISSN
0042-1138
- Publication type
Article
- DOI
10.1159/000339161