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Abstract：
BACKGROUND: Fournier\'s gangrene (FG) is a life-threatening disease, even with early diagnosis and administration of vigorous treatment, its mortality rate is high. This study aimed to evaluate the factors relate to mortality in patients with FG or necrotising fasciitis managed in a referral center.
METHODS: This retrospective cross-sectional study was conducted on patients managed in a tertiary referral center, Tehran, Iran, from March 2009 to March 2019, with diagnosis of FG or necrotising fasciitis. The correlation between different demographic and clinical parameters with mortality was analysed and reported.
RESULTS: 73 cases with the mean age of 59.1 ± 15.8 (range: 25 - 88) years were studied (87.7% male). 21 (28.8%) patients died. Escherichia coli (26 cases, 35.6%) was the most frequent microorganism in cultures. Non-survived cases had higher mean age (p = 0.01), higher frequency of hyperlipidaemia (p = 0.02), immunosuppression (p < 0.001), longer hospital stay (p=0.02), lower blood pressure (p=0.01), and lower platelet count (p=<0.001). Based on multivariate analysis, age (p = 0.015; Odds: 0.88 (0.79-0.97)), haematocrit level (p = 0.01; Odds: 1.27 (1.04-1.55)), platelet count (p = 0.03; Odds: 10.11 (1.14-89.35)), and immunosuppression (p = 0.01; Odds: 0.01 (0.0-0.54)) were independent related factors of mortality.
CONCLUSIONS: The rate of mortality due to FG and necrotizing fasciitis was 28.8%. Based on multivariate analysis, the independent related factors of mortality were older age, lower haematocrit level and platelet count, and presence of immunosuppression.
METHODS: This retrospective cross-sectional study was conducted on patients managed in a tertiary referral center, Tehran, Iran, from March 2009 to March 2019, with diagnosis of FG or necrotising fasciitis. The correlation between different demographic and clinical parameters with mortality was analysed and reported.
RESULTS: 73 cases with the mean age of 59.1 ± 15.8 (range: 25 - 88) years were studied (87.7% male). 21 (28.8%) patients died. Escherichia coli (26 cases, 35.6%) was the most frequent microorganism in cultures. Non-survived cases had higher mean age (p = 0.01), higher frequency of hyperlipidaemia (p = 0.02), immunosuppression (p < 0.001), longer hospital stay (p=0.02), lower blood pressure (p=0.01), and lower platelet count (p=<0.001). Based on multivariate analysis, age (p = 0.015; Odds: 0.88 (0.79-0.97)), haematocrit level (p = 0.01; Odds: 1.27 (1.04-1.55)), platelet count (p = 0.03; Odds: 10.11 (1.14-89.35)), and immunosuppression (p = 0.01; Odds: 0.01 (0.0-0.54)) were independent related factors of mortality.
CONCLUSIONS: The rate of mortality due to FG and necrotizing fasciitis was 28.8%. Based on multivariate analysis, the independent related factors of mortality were older age, lower haematocrit level and platelet count, and presence of immunosuppression.
摘要：
背景：Fournier坏疽（FG）是一种危及生命的疾病，即使早期诊断和给予剧烈治疗，它的死亡率很高。本研究旨在评估在转诊中心治疗的FG或坏死性筋膜炎患者的死亡率相关因素。
方法：这项回顾性横断面研究是针对在三级转诊中心管理的患者进行的，德黑兰,伊朗,2009年3月至2019年3月，诊断为FG或坏死性筋膜炎。分析并报告了不同人口统计学和临床参数与死亡率之间的相关性。
结果：研究了73例，平均年龄为59.1±15.8（范围：25-88）岁（男性占87.7％）。21例(28.8%)患者死亡。大肠杆菌（26例，35.6%）是培养物中最常见的微生物。未存活病例的平均年龄较高(p=0.01)，高脂血症的发生率较高（p=0.02），免疫抑制（p<0.001），住院时间更长（p=0.02），降低血压（p=0.01），和较低的血小板计数（p=<0.001）。基于多变量分析，年龄（p=0.015；赔率：0.88（0.79-0.97）），血细胞比容水平（p=0.01；赔率：1.27（1.04-1.55）），血小板计数（p=0.03；赔率：10.11（1.14-89.35）），和免疫抑制（p=0.01；赔率：0.01（0.0-0.54））是死亡率的独立相关因素。
结论：FG和坏死性筋膜炎的死亡率为28.8%。基于多变量分析，死亡率的独立相关因素是年龄，较低的血细胞比容水平和血小板计数，和免疫抑制的存在。
方法：这项回顾性横断面研究是针对在三级转诊中心管理的患者进行的，德黑兰,伊朗,2009年3月至2019年3月，诊断为FG或坏死性筋膜炎。分析并报告了不同人口统计学和临床参数与死亡率之间的相关性。
结果：研究了73例，平均年龄为59.1±15.8（范围：25-88）岁（男性占87.7％）。21例(28.8%)患者死亡。大肠杆菌（26例，35.6%）是培养物中最常见的微生物。未存活病例的平均年龄较高(p=0.01)，高脂血症的发生率较高（p=0.02），免疫抑制（p<0.001），住院时间更长（p=0.02），降低血压（p=0.01），和较低的血小板计数（p=<0.001）。基于多变量分析，年龄（p=0.015；赔率：0.88（0.79-0.97）），血细胞比容水平（p=0.01；赔率：1.27（1.04-1.55）），血小板计数（p=0.03；赔率：10.11（1.14-89.35）），和免疫抑制（p=0.01；赔率：0.01（0.0-0.54））是死亡率的独立相关因素。
结论：FG和坏死性筋膜炎的死亡率为28.8%。基于多变量分析，死亡率的独立相关因素是年龄，较低的血细胞比容水平和血小板计数，和免疫抑制的存在。
