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Outcome analysis in patients with primary necrotizing fasciitis of the male genitalia.

Publication ,  Journal Article
Dahm, P; Roland, FH; Vaslef, SN; Moon, RE; Price, DT; Georgiade, GS; Vieweg, J
Published in: Urology
July 2000

OBJECTIVES: To characterize patients with primary necrotizing fasciitis of the male genitalia (Fournier's gangrene) and to identify risk factors and prognostic variables of survival. METHODS: Fifty consecutive patients with primary necrotizing fasciitis of the male genitalia treated at our institution during a 15-year period between 1984 and 1998 were retrospectively analyzed. Of these patients, 44 (88.0%) were found to be eligible for analysis of the outcome parameters. Univariate survival analysis was performed using the Kaplan-Meier algorithm followed by multivariate analysis of statistically significant variables. Six patients (12.0%) who were severely immunocompromised were studied separately. RESULTS: Medical comorbidities were prevalent, with diabetes being the most common condition (50%). The overall mortality rate was 20% (10 of 50). Three statistically significant predictors of outcome were identified among the variables analyzed. These were the extent of the infection (P = 0.0262), the depth of the necrotizing infection (P = 0.0107), and treatment with hyperbaric oxygen (P = 0.0115). Multivariate regression analysis of these variables identified the extent of the infection (P = 0.0234) as the only statistically significant, independent predictor of outcome in the presence of other covariables. CONCLUSIONS: The involved body surface area appears to be the most important prognostic variable, with a significant impact on outcome. Given the high mortality of the disease entity and a trend toward the improved survival of patients receiving hyperbaric oxygen, this treatment form appears indicated in more severe cases. Immunocompromised patients, who frequently have an atypical and fulminant clinical course, appear to constitute a separate group with a dismal prognosis.

Duke Scholars

Published In

Urology

DOI

ISSN

0090-4295

Publication Date

July 2000

Volume

56

Issue

1

Start / End Page

31 / 35

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Retrospective Studies
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Humans
  • Genital Diseases, Male
  • Fasciitis, Necrotizing
  • Aged
  • Adult
 

Citation

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ICMJE
MLA
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Dahm, P., Roland, F. H., Vaslef, S. N., Moon, R. E., Price, D. T., Georgiade, G. S., & Vieweg, J. (2000). Outcome analysis in patients with primary necrotizing fasciitis of the male genitalia. Urology, 56(1), 31–35. https://doi.org/10.1016/s0090-4295(00)00604-x
Dahm, P., F. H. Roland, S. N. Vaslef, R. E. Moon, D. T. Price, G. S. Georgiade, and J. Vieweg. “Outcome analysis in patients with primary necrotizing fasciitis of the male genitalia.Urology 56, no. 1 (July 2000): 31–35. https://doi.org/10.1016/s0090-4295(00)00604-x.
Dahm P, Roland FH, Vaslef SN, Moon RE, Price DT, Georgiade GS, et al. Outcome analysis in patients with primary necrotizing fasciitis of the male genitalia. Urology. 2000 Jul;56(1):31–5.
Dahm, P., et al. “Outcome analysis in patients with primary necrotizing fasciitis of the male genitalia.Urology, vol. 56, no. 1, July 2000, pp. 31–35. Pubmed, doi:10.1016/s0090-4295(00)00604-x.
Dahm P, Roland FH, Vaslef SN, Moon RE, Price DT, Georgiade GS, Vieweg J. Outcome analysis in patients with primary necrotizing fasciitis of the male genitalia. Urology. 2000 Jul;56(1):31–35.
Journal cover image

Published In

Urology

DOI

ISSN

0090-4295

Publication Date

July 2000

Volume

56

Issue

1

Start / End Page

31 / 35

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Retrospective Studies
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Humans
  • Genital Diseases, Male
  • Fasciitis, Necrotizing
  • Aged
  • Adult