Fournier 괴저 중증도지수를 이용한 Fournier 괴저와 음낭 농양의 예후인자의 비교
Comparison between Fournier’s Gangrene and Scrotal Abscess Using Fournier’s Gangrene Severity Index
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Purpose: To evaluate effective factors in the survival of patients with Fournier’s gangrene (FG) and scrotal abscess, and to determine the validity of the Fournier’s gangrene severity index (FGSI), which was designed for determining disease severity in these patients. Materials and Methods: Twenty-eight men who treated for FG were enrolled. The data were evaluated about medical history, extent of body surface area involved (%), and the FGSI, which index presents patients’ vital signs (body temperature, heart and respiratory rates) and metabolic parameters (serum sodium, potassium, creatinine, bicarbonate, hematocrit, and white blood cell count). All the patients had antibiotic treatment and radical surgical debridement. The data were assessed according to whether the patient of FG survived or died, and also compared in patients with scrotal abscess (n=26). Results: Of the evaluated 28 FG patients, 6 died (21.4%). The difference in median age between survivors (57.5 years) and those who died (69.0 years) was not significant (p=0.18). Escherichia coli is the most common pathogen in 25% of FG and 15% of scrotal abscess patients. The median extent of the body surface area involved in patients who survived and died was 2.5% and 3.5%, respectively (p =0.13). However, the median FGSI scores for nonsurvivors and survivors of FG, and patients of scrotal abscess were 10.0±3.6, 3.3±2.6, and 0.9±2.6, respectively (p＜0.01). The heart rate and serum creatinine level at the admission were significant prognostic parameters in patients with FG. Conclusions: The FGSI score appeared to be predicts the disease severity and the patient's survival in patients with FG and scrotal abscess.
Abstract
Purpose: To evaluate effective factors in the survival of patients with Fournier’s gangrene (FG) and scrotal abscess, and to determine the validity of the Fournier’s gangrene severity index (FGSI), which was designed for determining disease severity in these patients. Materials and Methods: Twenty-eight men who treated for FG were enrolled. The data were evaluated about medical history, extent of body surface area involved (%), and the FGSI, which index presents patients’ vital signs (body temperature, heart and respiratory rates) and metabolic parameters (serum sodium, potassium, creatinine, bicarbonate, hematocrit, and white blood cell count). All the patients had antibiotic treatment and radical surgical debridement. The data were assessed according to whether the patient of FG survived or died, and also compared in patients with scrotal abscess (n=26). Results: Of the evaluated 28 FG patients, 6 died (21.4%). The difference in median age between survivors (57.5 years) and those who died (69.0 years) was not significant (p=0.18). Escherichia coli is the most common pathogen in 25% of FG and 15% of scrotal abscess patients. The median extent of the body surface area involved in patients who survived and died was 2.5% and 3.5%, respectively (p =0.13). However, the median FGSI scores for nonsurvivors and survivors of FG, and patients of scrotal abscess were 10.0±3.6, 3.3±2.6, and 0.9±2.6, respectively (p＜0.01). The heart rate and serum creatinine level at the admission were significant prognostic parameters in patients with FG. Conclusions: The FGSI score appeared to be predicts the disease severity and the patient's survival in patients with FG and scrotal abscess.
참고문헌 (21)
- Fournier JR, "Gangrene foudroyante de la verge", Medicin Pratique, 4, pp.597~598 (1883)
- Spirnak JP, "Fournier's gangrene: report of 20 patients", J Urol, 131, pp.289~291 (1984)
- 임승대, "Fournier 괴저의 예후인자에 대한 연구", Korean Journal of Urology, 43(5), pp.412~417 (2002), 대한비뇨기과학회
- 김병훈, "Fournier's Gangrene의 적극적 치료의 필요성", Korean Journal of Urology, 45(8), pp.793~799 (2004), 대한비뇨기과학회
- Weiner DM, "Gangrene of the male genitalia", AUA Update Series, 17, pp.41~47 (1998)
- Laor E, "Outcome prediction in patients with Fournier's gangrene", J Ur, 154, pp.89~92 (1995)
- Lin E, "Is Fournier's gangrene severity index useful for predicting outcome of Fournier's gangrene?", Urol In, 75, pp.119~122 (2005)
- Tuncel A, "Fournier's gangrene: Three years of experience with 20 patients and validity of the Fournier's Gangrene Severity Index Score", Eur Urol, 50, pp.838~843 (2006)
- Hwang EC, "Fournier’s gangrene: six years of experience with 33 patients and validity of the Fournier’s gangrene severity index score in Korean patients", Korean J UTII, 5, pp.199~206 (2010)
- Curreri PW, "Burns, In Principles of surgery", pp.285~306 (1989), McGraw-Hill Book Co.
- Laucks SS, "Fournier's gangrene", Surg Clin North Am, 74, pp.1339~1352 (1994)
- Eke N, "Fournier's gangrene: a review of 1726 cases", Br J Surg, 87, pp.718~728 (2000)
- Smith GL, "Fournier's gangrene", Br J Urol, 81, pp.347~355 (1998)
- Palmer LS, "The limited impact of involved surface area and surgical débridement on survival in Fournier's gangrene", Br J Urol, 76, pp.208~212 (1995)
- Korkut M, "Outcome analysis in patients with Fournier's gangrene: report of 45 cases", Dis Colon Rectum, 46, pp.649~652 (2003)
- Steffen EK, "Hydrolytic enzymes of anaerobic bacteria isolated from human infections", J Clin Microbiol, 14, pp.153~156 (1981)
- Pizzorno R, "Hyperbaric oxygen therapy in the treatment of Fournier's disease in 11 male patients.", J Urol, 158, pp.837~840 (1997)
- Clayton MD, "presentation and survival of fifty-seven patients with necrotizing fasciitis of the male genitalia", Surg Gynecol Obstet, 170, pp.49~55 (1990)
- Asci R, "Fournier's gangrene: risk assessment and enzymatic debridement with lyophilized collagenase application", Eur Urol, 34, pp.411~418 (1998)
- Chawla SN, "Fournier's gangrene: an analysis of repeated surgical debridement", Eur Urol, 43, pp.572~575 (2003)
- Kilic A, "Fournier's gangrene: etiology, treatment, and complications", Ann Plast Surg, 47, pp.523~527 (2001)