Palvolgyi et al developed a simple model for early prediction of Fournier’s gangrene. It can help to identify a patient who may be a candidate for early surgery. The authors are from Harbor UCLA Medical Center in Los Angeles.
Goal: to distinguish necrotizing from non-necrotizing (cellulitis, abscess) infections of external genitalia, perineum and perianal areas
Parameters on admission:
(1) heart rate in beats per minute
(2) serum sodium in mmol/L
(3) serum BUN in mg/dL
(4) white blood cell count per µL
Parameter
Finding
Points
heart rate
<= 110 beats per minute
0
> 110 beats per minute
1
serum sodium
>= 135 mmol/L
0
< 135 mmol/L
1
serum BUN
<= 15 mg/dL
0
> 15 mg/dL
1
white blood cell count
<= 15,000 per µL
0
> 15,000 per µL
2
where:
• The model of Wall et al has similar cutoffs for serum sodium and the WBC count.
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• The higher the score the more greater the risk of Fournier’s gangrene.
• A score >= 2 had a sensitivity of 84% and specificity of 69%.
• A score >= 3 had a sensitivity of 68% and specificity of 91%.
Performance:
• The area under the ROC curve was 0.85.
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