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29-Sep-2020
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Arch Hellen Med, 37(5), September-October 2020, 650-655 ORIGINAL PAPER The predictors of mortality in patients with anogenital necrotizing fasciitis (Fournier's gangrene) A. Simsek,1 A. Dirican,1 I. Gecit2 |
OBJECTIVE To evaluate the predictors of mortality in the Fournier's gangrene form of necrotizing fasciitis (NF).
METHOD The medical records of patients with anogenital NF who were treated in a tertiary care hospital between January 2010 and December 2018 were reviewed, retrospectively.
RESULTS This study included 86 patients, 76 males and 10 females. Perianal abscess (30.2%) was the leading precipitating event causing NF. The scrotum and perineum were the most commonly affected sites, 73.2% and 40.7%, respectively. NF extended beyond the urogenital and or anorectal triangle in 30.2% of cases. Escherichia coli (E. coli) was the most common microorganism isolated in tissue cultures (55.3%), and Klebsiella pneumoniae the second most common (15.3%). Admission to the intensive care unit (ICU) was required for 50 patients (58.1%), and the mortality rate was 23.3%. Older age (>60 years), smoking, and extension of the infection beyond the urogenital and or anorectal triangle were all significantly associated with mortality.
CONCLUSIONS Age >60 years, smoking, and extension of the infection beyond urogenital and or anorectal triangle were significantly related with mortality in anogenital NF. Prompt diagnosis and timely intervention are essential to prevent spread of the infection.
Key words: Fournier's gangrene, Mortality, Necrotizing fasciitis, Necrotizing soft tissue infections.
