Prognostic determinants and treatment outcomes of Fournier's Gangrene treatment in a resource-limited setting: A retrospective study

Authors

Saif Ghabisha, Department of General Surgery, School of Medicine, Ibb University of Medical Sciences, Ibb. saifalighabisha@yahoo.com.Follow
Faisal Ahmed, Department of Urology, School of Medicine, Ibb University of Medical Sciences, Ibb. fmaaa2006@yahoo.com.Follow
Saleh Al-Wageeh, Department of General Surgery, School of Medicine, Ibb University of Medical Sciences, Ibb. alwajihsa78@gmail.com.Follow
Mohamed Badheeb, Department of Internal Medicine, Yale New Haven Health, Bridgeport Hospital, Bridgeport. badheeb2009@gmail.com.Follow
Qasem Alyhari, Department of General Surgery, School of Medicine, Ibb University of Medical Sciences, Ibb. qalyhary@hotmail.com.
Abdulfattah Altam, Department of General Surgery, School of Medicine, 21 September University, Sana'a. dral_tam@yahoo.com.
Afaf Alsharif, Department of Gynaecology, School of Medicine, Jeblah University for Medical and Health Sciences, Ibb. afafmussa2018@gmail.com.Follow

Document Type

Article

Publication Title

Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica

Abstract

BACKGROUND: Fournier's gangrene (FG) is a destructive necrotizing infection with a generally poor prognosis. This study aims to share our experience in handling FG patients in a resource-limited setting and identify prognostic factors for FG mortality. METHODS: A retrospective study of thirty-six patients diagnosed with FG and treated at our teaching hospital between Jun 2010 to Oct 2022 was conducted. Laboratory and nonlaboratory data and patients' outcomes were gathered. A univariate analysis was computed for identifying prognostic factors for FG mortality. RESULT: The main age was 68.30 ± 5.61years and most (69.4%) were older than 65 years. The overall survival was 63.9% and the mortality rate was 36.1%. Univariate analysis showed that advanced age (p = 0.02), delayed in hospital presentation (p = 0.024), involvement of larger area (p = 0.001), a history of diabetes mellitus (p < 0.006), end-stage renal disease (p = 0.018), heart failure (p = 0.005), cerebrovascular accident (p = 0.003), liver cirrhosis (p = 0.001), presence of multiple comorbidities (p = 0.001), septic conditions at admission (p = 0.048), need for mechanical ventilation (p = 0.001), hypoalbuminemia (p < 0.001), and elevated blood urea nitrogen (p = 0.002) were found to be risk factors for mortality in patients with FG. CONCLUSIONS: Fournier's gangrene is a fulminant condition with a high mortality rate, especially in resource-limited settings. In this study, the mortality rate was 36.1%. Advanced age, delayed in hospital presentation, involvement of larger area, a history of diabetes mellitus, end-stage renal disease, heart failure, cerebrovascular accident, liver cirrhosis, presence of multiple comorbidities, septic conditions at admission, need for mechanical ventilation, hypoalbuminemia, and elevated blood urea nitrogen were associated with FG mortality.

First Page

11450

DOI

10.4081/aiua.2023.11450

Publication Date

7-25-2023

Recommended Citation

Ghabisha, Saif; Ahmed, Faisal; Al-Wageeh, Saleh; Badheeb, Mohamed; Alyhari, Qasem; Altam, Abdulfattah; and Alsharif, Afaf, "Prognostic determinants and treatment outcomes of Fournier's Gangrene treatment in a resource-limited setting: A retrospective study" (2023). Internal Medicine. 38.
https://scholar.bridgeporthospital.org/internal_medicine/38

Identifier

37491981 (pubmed); 10.4081/aiua.2023.11450 (doi)