Bulent Erol1, Altug Tuncel2, Adem Tok3, Volkan Hanci4, Utku Sari5, Furkan Sendogan5, Salih Budak6, Huseyin Aydemir7, Akin Soner Amasyali8, Asif Yildirim5, Turhan Caskurlu5. 1. Department of Urology, Istanbul Medeniyet University Faculty of Medicine, Dr. Erkin Cad. Istanbul Medeniyet Universitesi Goztepe Eğitim Arastirma Hastanesi, Kadikoy/Istanbul, Turkey. erolbulent@yahoo.com. 2. Department of Urology, Ankara Numune Training and Research Hospital, Ankara, Turkey. 3. Department of Urology, Bulent Ecevit University Faculty of Medicine, Zonguldak, Turkey. 4. Department of Anesthesiology, Dokuz eylul University Faculty of Medicine, Izmir, Turkey. 5. Department of Urology, Istanbul Medeniyet University Faculty of Medicine, Dr. Erkin Cad. Istanbul Medeniyet Universitesi Goztepe Eğitim Arastirma Hastanesi, Kadikoy/Istanbul, Turkey. 6. Department of Urology, Izmir Tepecik Training and Research Hospital, Izmir, Turkey. 7. Department of Urology, Sakarya Training and Research Hospital, Sakarya, Turkey. 8. Department of Urology, Adnan Menderes University, Faculty of Medicine, Aydin, Turkey.
Abstract
INTRODUCTION: We evaluated low magnesium levels and three different scoring systems including the Fournier's Gangrene Severity Index (FGSI), the Uludag Fournier's Gangrene Severity Index (UFGSI), and the Charlson Comorbidity Index (CCI) for predicting mortality in a multicentric, large patient population with FG. METHODS: The medical records of 99 FG patients who were treated and followed up in different clinics were reviewed. The biochemical, hematological, and bacteriological results from the admission evaluation were recorded. The CCI, FGSI, and UFGSI were evaluated and stratified by survival. RESULTS: The results were evaluated for the following patients: the survivors (n = 82) and the nonsurvivors (n = 17). The magnesium level for the survivors and nonsurvivors was 2.09 ± 0.28 and 1.68 ± 0.23, respectively (p 0.004). The admission FGSI, UFGSI, and CCI scores were significantly higher in nonsurvivors (p 0.001, p 0.001, p < 0.001, respectively). The receiver operating characteristics analysis revealed that the UFGSI was more powerful than the FGSI. The hypomagnesemia, low hemoglobin and hematocrit, low albumin and HCO3 levels; high alkaline phosphatase; and the high heart and respiratory rates, an FGSI >9, rectal involvement, and a high CCI were associated with a worse prognosis. CONCLUSION: Low magnesium levels might be an important parameter for a worse FG prognosis. Monitoring the serum magnesium levels might have prognostic and therapeutic implications in patients with FG. High CCI, FGSI, and UFGSI scores might be associated with a worse prognosis in patients with FG. The UFGSI might be more powerful scoring system than the FGSI.
INTRODUCTION: We evaluated low magnesium levels and three different scoring systems including the Fournier's Gangrene Severity Index (FGSI), the Uludag Fournier's Gangrene Severity Index (UFGSI), and the Charlson Comorbidity Index (CCI) for predicting mortality in a multicentric, large patient population with FG. METHODS: The medical records of 99 FG patients who were treated and followed up in different clinics were reviewed. The biochemical, hematological, and bacteriological results from the admission evaluation were recorded. The CCI, FGSI, and UFGSI were evaluated and stratified by survival. RESULTS: The results were evaluated for the following patients: the survivors (n = 82) and the nonsurvivors (n = 17). The magnesium level for the survivors and nonsurvivors was 2.09 ± 0.28 and 1.68 ± 0.23, respectively (p 0.004). The admission FGSI, UFGSI, and CCI scores were significantly higher in nonsurvivors (p 0.001, p 0.001, p < 0.001, respectively). The receiver operating characteristics analysis revealed that the UFGSI was more powerful than the FGSI. The hypomagnesemia, low hemoglobin and hematocrit, low albumin and HCO3 levels; high alkaline phosphatase; and the high heart and respiratory rates, an FGSI >9, rectal involvement, and a high CCI were associated with a worse prognosis. CONCLUSION: Low magnesium levels might be an important parameter for a worse FG prognosis. Monitoring the serum magnesium levels might have prognostic and therapeutic implications in patients with FG. High CCI, FGSI, and UFGSI scores might be associated with a worse prognosis in patients with FG. The UFGSI might be more powerful scoring system than the FGSI.
Authors: Florian Roghmann; Christian von Bodman; Björn Löppenberg; Andreas Hinkel; Jüri Palisaar; Joachim Noldus Journal: BJU Int Date: 2012-04-11 Impact factor: 5.588