Usefulness of FGSI and UFGSI scoring systems for predicting mortality in patients with Fournier's gangrene: A multicenter study

BACKGROUND: This study aimed to evaluate the usefulness of Fournier's gangrene scoring index (FGSI) and Uludag FGSI (UFGSI) for predicting mortality in patients with FG. METHODS: Patients who underwent treatment and follow- up in the A division department of general surgery at two education and research hospitals between January 2012 and December 2015 were evaluated for mortality- related factors. The sensitivities of FGSI and UFGSI scoring systems for predicting mortality- related factors and disease prognosis were evaluated. Patients were grouped as survivors (Group I) or non-survivors (Group II). RESULTS: In total, 29 patients were included in the study. The mean age (+/- SD) was 51.52 +/- 13.36 years. The mortality rate was 20.6% (six patients). Bacterial growth was observed in wound cultures of 17 patients (58.6%). Of the patients with bacterial growth, 11 (47.8%) were in Group I and six (100%) were in Group II. The presence of bacterial growth was significantly associated with mortality (p=0.028). Fourteen patients (48.3%) had comorbid conditions. The number of comorbid conditions was related (p=0.049). FGSI and UFGSI scores were significantly higher in Group II than in Group I (p=0.002 and p=0.001, respectively). Among UFGSI parameters, extent of disease, body temperature, pulse rate, and HCO3 values were significantly higher in Group II than in Group I (p<0.05). The FGSI and UFGSI scoring systems had 100% sensitivity and 78.2% and 73.9% specificity, respectively, for predicting mortality. CONCLUSION: The FGSI and UFGSI scoring systems are valuable for predicting mortality in patients with FG. The extent of the disease was an important prognostic parameter in this study. Whichever scoring system is used, we suggest the use of the extent of disease score in UFGSI.