Yilmazlar et al reported a scoring system for Fournier's gangrene. This can help to identify a patient who requires more aggressive management. The authors are from Uludag University in Turkey.
Pateint selection: Fournier's gangrene
Parameters:
(1) age in years
(2) dissemination score
(3) temperature in °C
(4) heart rate in beats per minute
(5) respiratory rate in breaths per minute
(6) serum potassium in mmol/L
(7) serum sodium in mmol/L
(8) serum creatinine in mg/dL
(9) hematocrit in percent
(10) white blood cell count per microliter
(11) venous serum bicarbonate in mmol/L
|
Parameter |
Finding |
Points |
|
age in years |
< 60 years |
0 |
|
|
>= 60 years |
1 |
|
dissemination |
confined to urogenital or anorectal area |
1 |
|
|
confined to pelvic region |
2 |
|
|
beyond pelvic region |
6 |
|
temperature |
>= 41 |
4 |
|
|
39 to 40.9 |
3 |
|
|
38.5 to 38.9 |
1 |
|
|
36 to 38.4 |
0 |
|
|
34 to 35.9 |
1 |
|
|
32 to 33.9 |
2 |
|
|
30 to 31.9 |
3 |
|
|
<= 29.9 |
4 |
|
heart rate |
>= 180 |
4 |
|
|
140 to 179 |
3 |
|
|
110 to 139 |
2 |
|
|
70 to 109 |
0 |
|
|
55 to 69 |
2 |
|
|
40 to 54 |
3 |
|
|
<= 39 |
4 |
|
respiratory rate |
>= 50 |
4 |
|
|
35 to 49 |
3 |
|
|
25 to 34 |
1 |
|
|
12 to 24 |
0 |
|
|
10 to 11 |
1 |
|
|
6 to 9 |
2 |
|
|
<= 5 |
4 |
|
serum potassium |
>= 7 |
4 |
|
|
6 to 6.9 |
3 |
|
|
5.5 to 5.9 |
1 |
|
|
3.5 to 5.4 |
0 |
|
|
3 to 3.4 |
1 |
|
|
2.5 to 2.9 |
2 |
|
|
< 2.5 |
4 |
|
serum sodium |
>= 180 |
4 |
|
|
160 to 179 |
3 |
|
|
155 to 159 |
2 |
|
|
150 to 154 |
1 |
|
|
130 to 149 |
0 |
|
|
120 to 129 |
2 |
|
|
110 to 119 |
3 |
|
|
< 110 |
4 |
|
serum creatinine |
>= 3.5 |
4 |
|
|
2 to 3.4 |
3 |
|
|
1.5 to 1.9 |
2 |
|
|
0.5 to 1.4 |
0 |
|
|
< 0.6 |
2 |
|
|
acute renal failure |
times 2 |
|
hematocrit |
>= 60 |
4 |
|
|
50 to 59 |
2 |
|
|
46 to 49 |
1 |
|
|
30 to 45 |
0 |
|
|
20 to 29 |
2 |
|
|
< 20 |
4 |
|
WBC count x10^3/µL |
>= 40 |
4 |
|
|
20 to 39.9 |
2 |
|
|
15 to 19.9 |
1 |
|
|
3 to 14.9 |
0 |
|
|
1 to 2.9 |
2 |
|
|
< 1 |
4 |
|
serum bicarbonate |
>= 52 |
4 |
|
|
41 to 51 |
3 |
|
|
32 to 40 |
1 |
|
|
22 to 31 |
0 |
|
|
18 to 21 |
2 |
|
|
15 to 17 |
3 |
|
|
< 15 |
4 |
total UFGSI score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 1
• maximum score: 47
• A score > 9 had a 94% mortality rate.
• A score >= 9 had a 19% mortality rate.
Performance:
• The area under the ROC curve is 0.95.
