Fournier's gangrene: our experience with 50 patients and analysis of factors affecting mortality

被引:88
作者
Benjelloun, El Bachir [1 ]
Souiki, Tarik [1 ]
Yakla, Nadia [1 ]
Ousadden, Abdelmalek [1 ]
Mazaz, Khalid [1 ]
Louchi, Abdellatif [1 ]
Kanjaa, Nabil [2 ]
Taleb, Khalid Ait [1 ]
机构
[1] Univ Hosp Hassan II, Dept Surg, Fes, Morocco
[2] Univ Hosp Hassan II, Dept Anesthesiol & Intens Care, Fes, Morocco
来源
WORLD JOURNAL OF EMERGENCY SURGERY | 2013年 / 8卷
关键词
Fournier's gangrene; Mortality; Outcome analysis; SEVERITY INDEX SCORE; PROGNOSTIC-FACTORS; NECROTIZING FASCIITIS; OUTCOME PREDICTION; MALE GENITALIA; MANAGEMENT; SURVIVAL;
D O I
10.1186/1749-7922-8-13
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Introduction: Fournier's gangrene is a rare, rapidly progressive, necrotizing fasciitis of the external genitalia and perineum. Case series have shown a mortality rate of 20% to 40% with an incidence of as high as 88% in some reports. In this study we aimed to share our experience in the management of Fournier's gangrene and to identify risk factors that affect mortality. Methods: The medical records of 50 patients with Fournier's gangrene who presented at the University Hospital Hassan II of Fez from January 2003 to December 2009 were reviewed retrospectively to analyze the outcome and identify the risk factors and prognostic indicators of mortality. Results: Ten males and five females were enrolled in the study. The mean age was 54 years (range 23-81). The most common predisposing factor was diabetes mellitus (34%). E. coli was the most frequent bacterial organisms cultured. All patients were treated with a common approach of resuscitation, broad-spectrum antibiotics, and wide surgical excision. The mortality rate was 24%. The advanced age, renal failure on admission, extension of infection to the abdominal wall, occurrence of septic shock and need for postoperative mechanical ventilation are the main prognostic factors of mortality. In multivariate analysis, none of these variables is an independent predictor of mortality. Conclusions: Fournier's gangrene is still a very severe disease with high mortality rates. Early recognition of infection associated with invasive and aggressive treatment is essential for attempting to reduce these prognostic indices.
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页数:5
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