A new scoring system for the prediction of mortality in Fournier's gangrene: The Eğin score.

BACKGROUND

This study aimed to investigate the factors affecting mortality in Fournier's gangrene (FG) and to establish a simplified scoring system that enables practical bedside assessment for clinicians.

METHODS

The medical records of 130 patients treated for FG between February 2012 and January 2025 were retrospectively reviewed. Survivors (Group 1, n=101) were analyzed separately from non-survivors (Group 2, n=29). The collected data included sex, age, infection spread score, Uludag Fournier's Gangrene Severity Index (UFGSI), Fournier's Gangrene Severity Index (FGSI) scores, source of infection, presence of diabetes mellitus (DM), obesity, and other comorbidities. Additional variables included the presence of a diverting stoma, duration of vacuum-assisted closure (VAC) therapy, length of hospital stay, intensive care period (ICP), and isolated bacterial species. Associations between mortality and factors such as age, infection spread score, comorbidities other than DM and obesity (CADO), and ICP were examined.

RESULTS

A significant difference was observed between the groups in terms of age and age score. The infection spread score was significantly higher in Group 2. While 60 patients in Group 1 had CADO, all patients in Group 2 had CADO, demonstrating a statistically significant difference. ICP was also significantly longer among non-survivors. Receiver operating characteristic (ROC) analysis demonstrated that the Eğin score had a sensitivity of 96.6% and a specificity of 63.4% at a threshold value of >3.

CONCLUSION

Age, infection spread score, CADO, and ICP, which constitute the Eğin score, demonstrated significant differences between survivors and non-survivors. These parameters are crucial for predicting mortality in patients with FG.