Presentation Authors: David Adrian Fernandez Alcaraz*, Guadalupe, Mexico, Jhonataan Uribe Montoya, Andres Guillen Lozoya, Rodrigo Romero Mata, Monterrey, Mexico
Introduction: Fournier gangrene (FG) is a severe life-threatening infection of the genital and perineal area. it continues to be a challenge for the physician in general and is considered a mortal urological emergency. _x000D_
ObjectiveEvaluate the origin of Fournier gangrene (FG) is a prognostic factor of morbidity and mortality.
Methods: Patients who came to our clinic with a diagnosis of FG from 2010 to 2017 were included retrospectively. Patients were categorized depending on the origin of the infection. Three severity factors were determined in each group, days of hospital stay, the FG severity index (FGSI), and mortality. The chi-square test and logistic regression were used to perform the statistical analysis of the results.
Results: Of the 130 patients evaluated, the origin was established in 121 based on the clinical history and radiological and surgical findings. A total of 34 patients had an intestinal origin with a mean age of 50 years, a mean hospital stay of 10.8 days, a mean FGSI of 5.17, and a mortality of 17.14%. A total of six patients had a testicular origin with a mean age of 48.08 years, a mean hospital stay of 5.46 days, a mean FGSI of 3.02, and a mortality of 2.17%. Twelve patients had a urinary origin with a mean age of 56.5 years, a mean hospital stay of 11.25 days, a mean FGSI of 4.5, and a mortality of 0%. There were 28 patients with a cutaneous origin with a mean age of 46.4 years, a mean hospital stay of 7.4 days, a mean FGSI of 5.14, and a mortality of 14.28%. The testicular origin was the most frequent (38%) in addition to presenting a lower hospital stay, a lower FGSI, and a lower mortality than those with an intestinal origin 5.6 Â± 3 days (2.1%) vs 10.8 Â± 5.1 days (17.14%), respectively, p=0.005.
Conclusions: Early emphasis on treatment, which should be aggressive from the beginning, reduces mortality in patients with FG. The FGSI is useful and should be applied in each patient to establish severity; the origin should also be established to determine short, medium and long-term survival. The testicular origin is statistically significant with a good prognosis in relation to mortality.