Can We Predict Mortality in Patients with Fournier's Gangrene Using Questionnaires? A Pilot Study with Eighty-seven Patients

Objective: To investigate the validity and reliability of the Fournier's gangrene severity index (FSGI) and Uludag Fournier's gangrene severity index (UFGSI) scoring systems and their components in outcome prediction for patients with Fournier's gangrene. Materials and Methods: Recods of 87 patients, who were diagnosed with Fournier's gangrene in our clinic between March 2005 and May 2016, were retrospectively analyzed. The patients were divided into 2 groups as survivors and non-survivors. Parameters belonging to the groups were compared. Results: The overall mortality rate was 13.7%. There was no correlation between mortality and dissemination of disease to the rectum, lower abdomen or lower extremity (p>0.05). There was a significant difference in renal failure, heart rate, blood urea nitrogen, creatinine, calcium and serum bicarbonate (HCO3) values, and FSGI and UFGSI scores between the survivor and non-survivor groups (p<0.05). In evaluation of mortality, a cut-off value of >= 9 had a positive predictive value of 77.8% and 42.9% and negative predictive value of 93.6% and 95.5% for FGSI and UFGSI, respectively. Conclusion: To predict the prognosis in Fournier's gangrene, the FGSI and UFGSI are successful parameters especially in predicting mortality. In the light of these parameters, we assume that these scoring systems are useful in deciding which patient should receive more aggressive treatment.