# Diagnosis and Treatment Outcomes of Fournier’s Gangrene at a Tertiary Hospital

## TL;DR

This study examines the diagnosis and treatment outcomes of Fournier’s gangrene at a hospital in Vietnam, identifying risk factors and mortality rates.

## Contribution

The study provides insights into clinical characteristics, treatment approaches, and mortality predictors for Fournier’s gangrene in a Vietnamese tertiary hospital.

## Key findings

- The majority of Fournier’s gangrene cases originated from skin, gastrointestinal, or genitourinary infections.
- Diabetes mellitus was the most common risk factor, and mortality was associated with age, female sex, corticosteroid use, and septic shock.
- A combination of medical and surgical treatments was used, with an overall mortality rate of 18.3%.

## Abstract

Introduction

Fournier’s gangrene (FG) is a severe necrotizing fasciitis caused by polymicrobial agents. This study aims to evaluate the clinical and paraclinical characteristics, treatment outcomes, and factors related to mortality in patients with FG at People's Hospital 115, Vietnam.

Methods

A retrospective cohort study was conducted on all adult patients diagnosed with FG at People’s Hospital 115 from January 2018 to October 2024. Variables, including sociodemographic, clinical features, laboratory tests, and treatment outcomes, were collected. Data analysis was performed using SPSS version 26.0 (IBM Corp, Armonk, NY, USA).

Results

A total of 60 patients (47 males and 13 females) were enrolled; the mean age was 58.2 ± 12.6 years. The most common infection origins were from skin infections (36.7%), followed by the gastrointestinal tract (31.7%) and the genitourinary tract (30%). Most patients presented with symptoms such as perineal pain (98.3%), perianal swelling (91.7%), fever (48.3%), lower abdominal fluid collection (43.3%), and purulent discharge or perineal necrosis (31.7%). The most prevalent risk factor was diabetes mellitus (61.8%). Pathogenic bacteria that were commonly Escherichia coli, Klebsiella, and Proteus species could be isolated.

Treatment involved both medical management (resuscitation, broad-spectrum antibiotics, and wound care) and surgical interventions (debridement, necrotic tissue excision, and fecal and urinary diversion). The overall mortality rate was 18.3%. Factors significantly associated with mortality included advanced age, female sex, a history of long-term corticosteroid use, high severity index scores, and septic shock.

Conclusion

FG is an uncommon urological emergency that is a rapidly progressing disease with a high mortality rate. Early detection and aggressive treatment approaches to achieve better outcomes.