背景:Fournier坏疽是一种严重的外科传染病,各种危险因素都会增加其死亡率。这项研究的目的是回顾性分析Fournier坏疽患者的临床特征和实验室资料,然后分析与死亡率相关的危险因素.这项研究没有次要目标。
方法:本研究纳入2013年12月至2024年3月于苏州市中医医院确诊为Fournier坏疽的46例住院患者。从电子病历系统中提取所有患者的临床数据。收集的数据包括性别,年龄,疾病的持续时间,住院时间,感染部位,合并症,白细胞计数,血细胞比容,白蛋白,血糖,肌酐,血清钠,入院时血清钾,微生物培养结果,和患者预后(生存/死亡)。使用简化的Fournier坏疽严重指数(SFGSI)对所有患者进行评分。根据临床结果将患者分为存活和死亡组。使用χ²检验或Fisher精确检验比较分类变量之间的差异。使用学生t检验或曼-惠特尼U检验比较数值变量之间的差异。采用二元logistic回归分析Fournier坏疽死亡的危险因素。
结果:在46例Fournier坏疽患者中,男性39人(84.8%),女性7人(15.2%)。年龄从17岁到86岁,平均年龄为61岁。14例(30.4%)局限于肛周区域,26例(56.5%)筋膜坏死累及肛周,会阴,和生殖器区域,6例(13.0%)延伸至腹壁。术后3个月随访,43例患者(93.5%)存活,而3例患者(6.5%)因严重疾病入院后不久死亡。根据结果,将患者分为存活组43例和死亡组3例,分别。两组患者年龄差异有统计学意义(P<0.05)。延伸至腹壁(P<0.01),血细胞比容(P<0.01),白蛋白(P<0.01),SFGSI(P<0.01),SFGSI>2(P<0.01)。二元logistic回归分析显示红细胞压积降低是Fournier坏疽患者死亡的独立危险因素。
结论:本研究详细分析了Fournier坏疽患者的临床特征和死亡危险因素。这项研究的主要结果是血细胞比容降低是预测FG患者死亡率的独立危险因素。这些发现为临床医生提供了有价值的预后见解,强调早期识别和纠正血细胞比容降低对改善患者预后和生存率的重要性。
BACKGROUND: Fournier\'s Gangrene is a severe surgical infectious disease, and various risk factors can increase its mortality rate. The purpose of this study is to retrospectively analyze the clinical characteristics and laboratory data of Fournier\'s Gangrene patients, followed by an analysis of mortality-related risk factors. This study has no secondary objectives.
METHODS: This study included 46 hospitalized patients diagnosed with Fournier\'s Gangrene at Suzhou Traditional Chinese Medicine Hospital from December 2013 to March 2024. Clinical data for all patients were extracted from the electronic medical records system. The collected data included gender, age, duration of illness, length of hospital stay, sites of infection involvement, comorbidities, white blood cell count, hematocrit, albumin, blood glucose, creatinine, serum sodium, serum potassium upon admission, microbial culture results, and patient outcomes (survival/death). The Simplified Fournier Gangrene Severe Index (SFGSI) was used to score all patients. Patients were categorized into survival and death groups based on clinical outcomes. Differences between categorical variables were compared using the χ² test or Fisher\'s exact test. Differences between numerical variables were compared using Student\'s t-test or the Mann-Whitney U test. Binary logistic regression was employed to analyze the risk factors for mortality in Fournier\'s Gangrene.
RESULTS: Among the 46 Fournier\'s Gangrene patients, 39 were male (84.8%) and 7 were female (15.2%). The age ranged from 17 to 86 years, with a median age of 61 years. Fourteen cases (30.4%) were confined to the perianal area, 26 cases (56.5%) had fascial necrosis involving the perianal, perineal, and genital regions, while 6 cases (13.0%) extended to the abdominal wall. At a 3-month postoperative follow-up, 43 patients (93.5%) survived, while 3 patients (6.5%) died shortly after admission due to severe illness. Based on the outcome, patients were divided into survival and death groups with 43 and 3 cases, respectively. Significant differences were observed between the two groups in terms of age (P<0.05), extension to the abdominal wall (P<0.01), hematocrit (P<0.01), albumin (P<0.01), SFGSI (P<0.01), and SFGSI>2 (P<0.01). Binary logistic regression analysis indicated that decreased hematocrit was an independent risk factor for mortality in Fournier\'s Gangrene patients.
CONCLUSIONS: This study provides a detailed analysis of the clinical characteristics and risk factors for mortality in Fournier\'s Gangrene patients. The primary outcome of this study is that a decreased hematocrit is an independent risk factor for predicting mortality in FG patients. These findings offer valuable prognostic insights for clinicians, underscoring the importance of early identification and correction of reduced hematocrit to improve patient outcomes and survival rates.