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Abstract：
BACKGROUND: To predict testicular involvement in patients diagnosed with Fournier\'s gangrene (FG) using the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score and the site other than lower limb (SIARI) score.
METHODS: The medical records of 51 patients operated for FG in our clinic between December 2012 and April 2022 were evaluated retrospectively in this study. Patients\' demographics, and laboratory test results were compared with the testisticular involvement status. Patients with testisticular involvement (n = 10) were compared with patients without testicular involvement (n = 41). The SIARI score at initial admission was analysed using logistic regression analyses for its performance in predicting testicular involvement with FG. Receiver operating characteristics (ROC) curves and the area under the receiver operating characteristic curve (AUROC) were used to evaluate its discriminating ability.
RESULTS: The SIARI score had modest performance for diagnosing testicular involvement in FG patients, with ROC analysis showing an AUROC value of 0.83 (p < 0.001). With a SIARI cut-off score of ≥ 3, the sensitivity was 90% and the specificity was 68%. For a SIARI cut-off score of ≥ 5, the sensitivity was 40% and the specificity was 97%.
CONCLUSIONS: The ability of the SIARI score to discriminate FG with testicular involvement is modest. The SIARI score should be employed cautiously as a routine diagnostic tool for the prediction of testicular involvement in FG at the initial admission. More research is needed to develop a better understanding of the relationship between the SIARI score and testicular involvement in FG.
METHODS: The medical records of 51 patients operated for FG in our clinic between December 2012 and April 2022 were evaluated retrospectively in this study. Patients\' demographics, and laboratory test results were compared with the testisticular involvement status. Patients with testisticular involvement (n = 10) were compared with patients without testicular involvement (n = 41). The SIARI score at initial admission was analysed using logistic regression analyses for its performance in predicting testicular involvement with FG. Receiver operating characteristics (ROC) curves and the area under the receiver operating characteristic curve (AUROC) were used to evaluate its discriminating ability.
RESULTS: The SIARI score had modest performance for diagnosing testicular involvement in FG patients, with ROC analysis showing an AUROC value of 0.83 (p < 0.001). With a SIARI cut-off score of ≥ 3, the sensitivity was 90% and the specificity was 68%. For a SIARI cut-off score of ≥ 5, the sensitivity was 40% and the specificity was 97%.
CONCLUSIONS: The ability of the SIARI score to discriminate FG with testicular involvement is modest. The SIARI score should be employed cautiously as a routine diagnostic tool for the prediction of testicular involvement in FG at the initial admission. More research is needed to develop a better understanding of the relationship between the SIARI score and testicular involvement in FG.
摘要：
背景：使用坏死性筋膜炎的实验室风险指标（LRINEC）评分和下肢以外的部位（SIARI）评分来预测诊断为Fournier坏疽（FG）患者的睾丸受累。
方法：本研究回顾性评估了2012年12月至2022年4月在我们诊所接受FG手术的51例患者的病历。患者人口统计学，并将实验室检查结果与睾丸受累状态进行比较。有睾丸受累的患者（n=10）与无睾丸受累的患者（n=41）进行了比较。首次入院时的SIARI评分使用逻辑回归分析其在预测FG睾丸受累方面的表现。使用受试者工作特征（ROC）曲线和受试者工作特征曲线下面积（AUROC）来评估其辨别能力。
结果：SIARI评分在诊断FG患者睾丸受累方面具有适度的表现，ROC分析显示AUROC值为0.83(p<0.001)。SIARI截止评分≥3时，敏感性为90%，特异性为68%。对于≥5的SIARI截止评分，敏感性为40％，特异性为97％。
结论：SIARI评分区分FG伴睾丸受累的能力较弱。在初次入院时，应谨慎使用SIARI评分作为预测FG睾丸受累的常规诊断工具。需要更多的研究来更好地了解SIARI评分与FG中睾丸受累之间的关系。
方法：本研究回顾性评估了2012年12月至2022年4月在我们诊所接受FG手术的51例患者的病历。患者人口统计学，并将实验室检查结果与睾丸受累状态进行比较。有睾丸受累的患者（n=10）与无睾丸受累的患者（n=41）进行了比较。首次入院时的SIARI评分使用逻辑回归分析其在预测FG睾丸受累方面的表现。使用受试者工作特征（ROC）曲线和受试者工作特征曲线下面积（AUROC）来评估其辨别能力。
结果：SIARI评分在诊断FG患者睾丸受累方面具有适度的表现，ROC分析显示AUROC值为0.83(p<0.001)。SIARI截止评分≥3时，敏感性为90%，特异性为68%。对于≥5的SIARI截止评分，敏感性为40％，特异性为97％。
结论：SIARI评分区分FG伴睾丸受累的能力较弱。在初次入院时，应谨慎使用SIARI评分作为预测FG睾丸受累的常规诊断工具。需要更多的研究来更好地了解SIARI评分与FG中睾丸受累之间的关系。
