Analysis of mortality in Fournier's gangrene

Revista Brasileira de Coloproctologia

Capelhuchnik, Peretz¹  Candelária, Paulo de Azeredo Passos¹  Fang, Chia Bin¹  Klug, Wilmar Artur¹ 

[1] Santa Casa de São Paulo

关键词: Fournier's gangrene;    gangrene;    infection;    mortality.;   

DOI  :  10.1590/S0101-98802009000200006

学科分类：心脏病和心血管学

来源: Sociedade Brasileira de Coloproctologia

【 摘 要 】

BACKGROUND: Necrotizing fasciitis is a severe infection of soft tissues, and when it affects the perineum it is called Fournier's gangrene. Some controversy exists over the origin of the disease, but all studies identified correlations between infection and proctologic, urologic, gynecologic origin procedures or trauma. In addition, many other causes are commonly associated, such as diabetes mellitus, abuse of ethanol, malnutrition and immunodepression. It is a severe situation, and diagnosis and surgical therapeutics are emergency procedures, and antibiotics and operations are usually required.
OBJECTIVE: Evaluation of conditions related to the causes of death.
METHOD: Since 1998 to 2005 in Santa Casa de São Paulo Hospital has 43 Fournier's gangrene patients (39 male) age averege 54,8 years and this study analysed their gender, symptoms, evolution of the disease, associated diseases, medical and surgical procedures, sepsis, lung infection, extension of infection, number of debridements, Apache II physiologic index and causes of death.
RESULTS: The survivors was 33 pacients and overall mortality of 10 subjects (23.2%), was related to age, delay of treatment, Apache II index and occurence of sepsis and pneumonia. No correlations were found with gender, diabetes mellitus, weight loss, bacteriology, place of begining and extension of lesions, number of debridments or colostomy and cistostomy.
CONCLUSIONS: Mortality is related to treatment delay and sepsis. There is no statistical evidence of any relation with diabetes, colostomy or cistostomy.

【 授权许可】

CC BY-NC