A Simplified Prognostic Scoring System for Fournier's Gangrene

Abstract

Introduction: Fournier’s gangrene is an acute necrotizing fasciitis affecting the perineal, perianal regions and genitalia. The cornerstones of treatment Fournier’s gangrene are urgent necrotic tissue debridement, broad-spectrum antibiotics and resuscitation. Despite advanced management policies, mortality from Fournier’s gangrene is still high. The aim of this study was to present our experience in low-volume general hospital in the management of Fournier’s gangrene according to our advocated scoring system. Patients and methods: A total of 68 patients were classified according to age, body mass index, early detection, area involved and comorbidity. The author advocated an eight- scale simplified prognostic scoring system with a maximum score of eighteen points denoting the highest risk of mortality and a minimum score of eight points carrying a relatively lower risk of mortality. The primary end point of the study was disease-related death and the secondary end point was length of hospital stay. Results: There were three grades according out simplified prognostic scoring system; grade I from 8-10 points, grade II from 11-14 points and grade III from 15-18 points. Patients with grade I carried a lower mortality rate and less hospital stay than those with grade II and grade III. Conclusion: We tried to develop a reliable tool to predict severity of the disease, not only to identify patients at highest risk of major complications or death but also to provide a target for medical teams and researchers aiming to improve outcome and to collect beneficial information for proper management of patients with Fournier's gangrene.