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Abstract：
BACKGROUND: Fournier gangrene is an uncommon urological emergency caused by microbial agents, resulting in necrosis of the genitalia and perineum. This study aims to evaluate the outcomes of early diagnosis and management of Fournier gangrene at KAMC in Riyadh, Saudi Arabia.
METHODS: A retrospective cohort study was conducted at KAMC, Saudi Arabia. The study population included all adult patients diagnosed with Fournier gangrene between 2015 and 2022. Data analysis was performed using RStudio (RStudio, Boston, MA). Frequencies and percentages were used to present categorical data, while medians and interquartile ranges were used to express numerical variables.
RESULTS: The study included 41 patients with Fournier gangrene, the majority (95.12%) being male with a median age of 60 years. The most prevalent comorbidity was diabetes mellitus (85.37%). Ten patients presented to the hospital with sepsis, two of whom were in shock. Within 90 days of admission, two of them had expired. This resulted in a 20% mortality rate among septic patients. The mean FGSI in patients who had died during hospital stays was approximately two times the mean in surviving patients (8.17 and 4.32, respectively). The most utilized imaging study was a CT scan (70.7%). Most patients had undergone multiple debridements (87.7%). The median number of debridements per patient was three, and the interval between each debridement was three days. The most frequent tissue culture finding was mixed organisms, followed by Escherichia coli. Regarding empiric antibiotics, tazocin was the most used, accounting for 22.0%. The most frequently performed adjunctive procedure was the placement of a suprapubic catheter, accounting for 41.5%. Roughly 43.90% required a blood transfusion. Within 90 days of admission, six patients had died, which makes the mortality rate 14.6%. Four of them had died within 30 days of admission (9.76%).
CONCLUSIONS: Fournier gangrene is a surgical emergency that requires prompt attention and resuscitation, antibiotic therapy, and surgical debridement. The study identified the demographic factors of patients who presented with the disease and provided the incidence, mortality rate, and outcomes of the disease. It also identified specifics of the pharmacological and surgical management and hospital courses.
METHODS: A retrospective cohort study was conducted at KAMC, Saudi Arabia. The study population included all adult patients diagnosed with Fournier gangrene between 2015 and 2022. Data analysis was performed using RStudio (RStudio, Boston, MA). Frequencies and percentages were used to present categorical data, while medians and interquartile ranges were used to express numerical variables.
RESULTS: The study included 41 patients with Fournier gangrene, the majority (95.12%) being male with a median age of 60 years. The most prevalent comorbidity was diabetes mellitus (85.37%). Ten patients presented to the hospital with sepsis, two of whom were in shock. Within 90 days of admission, two of them had expired. This resulted in a 20% mortality rate among septic patients. The mean FGSI in patients who had died during hospital stays was approximately two times the mean in surviving patients (8.17 and 4.32, respectively). The most utilized imaging study was a CT scan (70.7%). Most patients had undergone multiple debridements (87.7%). The median number of debridements per patient was three, and the interval between each debridement was three days. The most frequent tissue culture finding was mixed organisms, followed by Escherichia coli. Regarding empiric antibiotics, tazocin was the most used, accounting for 22.0%. The most frequently performed adjunctive procedure was the placement of a suprapubic catheter, accounting for 41.5%. Roughly 43.90% required a blood transfusion. Within 90 days of admission, six patients had died, which makes the mortality rate 14.6%. Four of them had died within 30 days of admission (9.76%).
CONCLUSIONS: Fournier gangrene is a surgical emergency that requires prompt attention and resuscitation, antibiotic therapy, and surgical debridement. The study identified the demographic factors of patients who presented with the disease and provided the incidence, mortality rate, and outcomes of the disease. It also identified specifics of the pharmacological and surgical management and hospital courses.
摘要：
背景：Fournier坏疽是由微生物引起的罕见泌尿外科急症，导致生殖器和会阴坏死。本研究旨在评估利雅得KAMCFournier坏疽的早期诊断和治疗结果，沙特阿拉伯。
方法：在KAMC进行了一项回顾性队列研究，沙特阿拉伯。研究人群包括2015年至2022年间诊断为Fournier坏疽的所有成年患者。使用RStudio（RStudio，波士顿,MA).频率和百分比用于显示分类数据，而中位数和四分位数范围用于表示数值变量。
结果：该研究包括41例Fournier坏疽患者，大多数（95.12%）为男性，中位年龄为60岁。最常见的合并症是糖尿病(85.37%)。10名败血症患者到医院就诊,其中两个人感到震惊。入院后90天内，其中两个已经过期。这导致败血症患者的死亡率为20％。在住院期间死亡的患者的平均FGSI大约是存活患者的平均FGSI的两倍(分别为8.17和4.32)。最常用的成像研究是CT扫描（70.7％）。大多数患者接受过多次清创术（87.7％）。每位患者的清创次数中位数为3次，每次清创之间的间隔为3天。最常见的组织培养发现是混合生物，其次是大肠杆菌。关于经验性抗生素，tazocin是最常用的,占22.0%。最常见的辅助手术是放置耻骨上导管，占41.5%。大约43.90%的人需要输血。入院后90天内，六名患者死亡，这使得死亡率为14.6%。其中4人在入院后30天内死亡(9.76%)。
结论：Fournier坏疽是一种需要及时注意和复苏的外科急症，抗生素治疗,和外科清创术。该研究确定了患有该疾病的患者的人口统计学因素，并提供了发病率，死亡率,和疾病的结果。它还确定了药理学和手术管理以及医院课程的细节。
方法：在KAMC进行了一项回顾性队列研究，沙特阿拉伯。研究人群包括2015年至2022年间诊断为Fournier坏疽的所有成年患者。使用RStudio（RStudio，波士顿,MA).频率和百分比用于显示分类数据，而中位数和四分位数范围用于表示数值变量。
结果：该研究包括41例Fournier坏疽患者，大多数（95.12%）为男性，中位年龄为60岁。最常见的合并症是糖尿病(85.37%)。10名败血症患者到医院就诊,其中两个人感到震惊。入院后90天内，其中两个已经过期。这导致败血症患者的死亡率为20％。在住院期间死亡的患者的平均FGSI大约是存活患者的平均FGSI的两倍(分别为8.17和4.32)。最常用的成像研究是CT扫描（70.7％）。大多数患者接受过多次清创术（87.7％）。每位患者的清创次数中位数为3次，每次清创之间的间隔为3天。最常见的组织培养发现是混合生物，其次是大肠杆菌。关于经验性抗生素，tazocin是最常用的,占22.0%。最常见的辅助手术是放置耻骨上导管，占41.5%。大约43.90%的人需要输血。入院后90天内，六名患者死亡，这使得死亡率为14.6%。其中4人在入院后30天内死亡(9.76%)。
结论：Fournier坏疽是一种需要及时注意和复苏的外科急症，抗生素治疗,和外科清创术。该研究确定了患有该疾病的患者的人口统计学因素，并提供了发病率，死亡率,和疾病的结果。它还确定了药理学和手术管理以及医院课程的细节。
