Factors affecting mortality in Fournier's gangrene: experience with fifty-two patients.

Abstract

INTRODUCTION: Fournier's gangrene (FG) is a life-threatening infection of the perineal and genital areas. We examined the comorbid diseases, treatments and factors affecting mortality in FG. METHODS: This retrospective clinical study involved 52 patients who were treated for FG. The demographics, aetiologies, comorbid diseases, laboratory and bacteriology findings, treatment methods and length of hospital stay were compared between patients who died and those who survived the infection. RESULTS: Out of the 52 patients, 12 died and 40 survived. Patients who died and those who survived were similar in terms of their mean age at first presentation (62 vs. 55 years), the mean number of debridements (3.6 vs. 2.9), the mean length of hospital stay (25 vs. 34 days) and gender (p > 0.05 for each). However, the mean leukocyte count was higher in patients who died than in surviving patients (33.6 ± 7.2 vs. 14.3 ± 4.9 cells/mml; p < 0.05). The most common aetiology in both groups was perianal abscess. Deviating colostomy was performed in 13 patients. Of the patients who died, nine had haemodialysis-dependent chronic renal failure and type II diabetes mellitus (DM), while one had type II DM and hypertension. CONCLUSION: Haemodialysis-dependent chronic renal failure and a high leukocyte count at first presentation were found to be the factors affecting mortality in FG patients.