A Fournier Gangrene Severity Index and Diabetes Mellitus: A Significance Correlation among Fournier Gangrene Patients in Single Center Hospital

Authors

  • Hanum Faeni Department of Surgery, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia
  • Wibisono Wibisono Department of Urology, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia
  • Galih Santosa Putra Department of Surgery, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia
  • Muhammad David Perdana Putra Department of Surgery, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2021.6401

Keywords:

Fournier gangrene, Fournier gangrene severity index, Diabetes mellitus

Abstract

BACKGROUND: Fournier gangrene (FG) is an urological emergency in the form of progressive necrotizing fascitis caused by polymicrobial infection which affects the perineum and external genitalia. FG that is not diagnosed and treated properly will result in severe morbidity and even mortality for the patient. The assessment of FG becomes clearer with the creation of a scoring system that predicts patient prognostic and therapeutic outcomes, known as the Fournier ganggreen severity index (FGSI). This FGSI includes clinical and laboratory examinations, namely, temperature, pulse, respiratory rate, levels of sodium, potassium, leukocytes, hematocrit, and blood serum bicarbonate.

AIM: We aimed to present descriptive retrospective study, which examined the relationship between age and DM with FGSI in FG patients at the Regional General Hospital.

METHODS: Data were taken from January 2017 to December 2020 at the Urology Department, dr. Moewardi Hospital Surakarta. There were 32 cases of FG patients, consisting of 20 patients with diabetes mellitus (DM) and 12 non-DM patients.

RESULTS: This study found that FG patients with an FGSI score <9 were 24 patients (75%), FG patients with an FGSI score of >9 were 8 patients (25%). Judging by the distribution of the FGSI score according to the age of the FG patient using the chi-square technique, the value p = 0.045. The p-value <0.05 means that at the 5% significance level the difference in the proportion of FGSI scores between age categories of FG patients is significant. The distribution of the FGSI score according to the DM comorbid showed that there were nine patients with an FGSI score of >9 (45.5%) with comorbid DM and no patients without the DM comorbid. Result of statistical test using the Chi-square technique was p = 0.036. The p-value < 0.05 means that at the 5% significance level the difference in the proportion of FGSI scores between patients with and without comorbid DM is significant.

CONCLUSION: Judging by the distribution of the FGSI score, it can be concluded that there is significant relationship between the age of the FG patient and the FGSI score and there is a significant relationship between the DM comorbid and the FGSI score in FG patients at dr. Moewardi Hospital Surakarta in the period January 2017 to December 2020.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Hohenfellner M, Santucci RA. Emergencies in Urology. Germany: Springer; 2007. p. 50-9.

Moslemi MK, Gilani MA, Moslemi AA, Arabshahi A. Fournier gangrene presenting in a patient with undiagnosed rectal adenocarcinoma: A case report. Cases J. 2009;2(12):9136. https://doi.org/10.1186/1757-1626-2-9136

Wein AJ, Schaeffer AJ, Schaeffer EM. Campbell Walsh Urology, Fournier Ganggrene. 10th ed. Philadelphia, PA: Elsivier; 2012. p. 324-5, 451-3.

Bonkat G, Bartoletti R, Bruyère F, Cai T, Geerlings SE, Köves B, et al. European Association of Urology Guidelines on Urological Infections, UK; 2020.

Michael TM. Urology, Urologic Emergencies: Fournier’s Ganggrene. 4th ed. United Kingdom: Lippincott Williams and Wilkins; 2006. p. 67.

Verma S, Sayana A, Kala S, Rai S. Evaluation of the utility of the Fournier’s Gangrene severity index in the management of Fournier’s Ganggrene in North India: A multicentre retrospective study. J Cutan Aesthet Surg. 2012;5(4):273-6. https://doi.org/10.4103/0974-2077.104916 PMid:23378710

Reynard J, Brewster SF, Biers S, Neal NL. Oxford Handbook of Urology, Infections and Inflammatory Conditions: Fournier’s Gangrene. 1st ed. United Kingdom: Oxford Medicine; 2006. p. 162. https://doi.org/10.1093/med/9780198783480.003.0006

Novick AC, Gill IS, Klein EA, Rackley R, Ross JH. Operative Urology at the Cleveland Clinic: Adult Scrotal Surgery. New Jersey: Humana Press; 2006. p. 538-41.

Kim IY. Gangrene: The Prognostic Factors and Validation of Severity Index in Fournier’s Ganggrene, Korea; 2011. Available from: https://www.intechopen.com/chapters/18911. [Last accessed on 2021 Aug 10].

Sorensen MD, Krieger JN, Rivara FP, Klein MB, Wessells H. Fournier’s Gangrene: Management and mortality predictors in a population based study. J Urol. 2009;182(6):2742-7. https://doi.org/10.1016/j.juro.2009.08.050 PMid:19837424

Gutierrez-Ochoa K, Castillo-de Lira HH, Velázquez-Macías RF, Landa-Soler M, Robles-Scott MA. Usefulness of Fournier’s Gangrene severity index: A comparative study. Rev Mex. 2010;70(1):27-30.

Barreda JT, Scheiding MM, Fernández CS, Campaña JM, Aguilera JR, Miranda EF, et al. Fournier gangrene. A retrospective study of 41 cases. Cir Esp. 2010;87(4):218-23. https://doi.org/10.1016/s2173-5077(10)70051-x PMid:20152961

Mallikarjuna MN, Vijayakumar A, Patil VS, Shivswamy BS. Fournier’s Gangrene: Current practices. ISRN Surg. 2012;2012:942437. https://doi.org/10.5402/2012/942437 PMid:23251819

Rochmah W. Diabetes Mellitus in the Elderly, Textbook of Internal Medicine. 4th ed. Jakarta: IPD FKUI; 2007. p. 1915-8.

American Diabetes Association, Standards of Medical Care in Diabetes, USA; 2010. Available from: https://care.diabetesjournals.org/content/27/suppl_1/s15. [Last accessed on 2021 Aug 10].

Downloads

Published

2021-08-08

How to Cite

1.
Faeni H, Wibisono W, Putra GS, Putra MDP. A Fournier Gangrene Severity Index and Diabetes Mellitus: A Significance Correlation among Fournier Gangrene Patients in Single Center Hospital. Open Access Maced J Med Sci [Internet]. 2021 Aug. 8 [cited 2021 Oct. 19];9(E):690-4. Available from: https://oamjms.eu/index.php/mjms/article/view/6401

Issue

Section

Public Health Epidemiology

Categories

Most read articles by the same author(s)