与男性相比，患有福尼尔坏疽的女性具有更高的发病率和死亡率：来自全国住院患者样本数据的见解。

Higher Morbidity and Mortality in Females With Fournier Gangrene Compared With Males: Insights From National Inpatient Sample Data.

作者信息

Abbasi Behzad, Hacker Emily, Ghaffar Umar, Hakam Nizar, Li Kevin D, Alazzawi Sultan, Fernandez Adrian, Patel Hiren V, Breyer Benjamin N

机构信息

Department of Urology, University of California San Francisco, San Francisco, California.

Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California.

出版信息

J Urol. 2025 Jan;213(1):99-109. doi: 10.1097/JU.0000000000004264. Epub 2024 Oct 2.

DOI:10.1097/JU.0000000000004264

PMID:39357026

Abstract

PURPOSE

We compare Fournier gangrene in female and male patients and identify mortality-associated characteristics in both.

MATERIALS AND METHODS

We used National Inpatient Sample data (2016-2020) to identify Fournier gangrene cases and extracted demographic, comorbidity, and procedural variables. Multivariable regression models were used to identify mortality risk factors for both cohorts.

RESULTS

We identified 2875 female (31%) and 6451 male patients (69%) with Fournier gangrene corresponding to an estimated 14,375 (95% CI, 13,784-14,966) and 32,255 (95% CI, 31,390-33,120) cases, respectively. Female patients were more likely to die than male patients (7.1% vs 5.7%, < .0001, respectively). The median incidence rates were 1.7 (interquartile range, 1.5-1.8) and 4 (interquartile range, 3.6-4.3) cases per 100,000 person-years for female and male patients, respectively. Female patients had higher median age, longer hospital stays, more charges, procedures, and fecal diversion rates, but lower routine discharges than male patients ( < .05). Non-White female patients had increased mortality odds compared with White female patients (odds ratio [OR], 1.49; 95% CI, 1.07-2.07; = .019). Prolonged interval until initial perineal debridement correlated with higher mortality odds in both female and male patients (OR, 1.02; 95% CI, 1-1.04; = .034 vs OR, 1.03; 95% CI, 1.01-1.05; < .0001). Diabetes lowered mortality odds in female and male patients (OR, 0.68; 95% CI, 0.47-0.99; = .046 vs OR, 0.54; 95% CI, 0.41-0.7; < .0001).

CONCLUSIONS

In female patients, Fournier gangrene incidence surpasses previous reports, with slightly worse outcomes compared with male patients, emphasizing the need for precise clinical assessment and early intensive interventions.

摘要

目的

我们比较女性和男性患者的福尼尔坏疽，并确定两者与死亡率相关的特征。

材料与方法

我们使用国家住院样本数据（2016 - 2020年）来识别福尼尔坏疽病例，并提取人口统计学、合并症和手术变量。多变量回归模型用于确定两个队列的死亡风险因素。

结果

我们识别出2875例女性（31%）和6451例男性患者（69%）患有福尼尔坏疽，估计分别对应14375例（95%可信区间，13784 - 14966）和32255例（95%可信区间，31390 - 33120）。女性患者比男性患者更易死亡（分别为7.1%对5.7%，P <.0001）。女性和男性患者每10万人年的发病率中位数分别为1.7（四分位间距，1.5 - 1.8）和4（四分位间距，3.6 - 4.3）例。女性患者的年龄中位数更高、住院时间更长、费用更高、手术更多、粪便转流率更高，但常规出院率低于男性患者（P <.05）。非白人女性患者与白人女性患者相比，死亡几率增加（优势比[OR]，1.49；95%可信区间，1.07 - 2.07；P =.019）。女性和男性患者中，直至初次会阴清创的间隔时间延长与更高的死亡几率相关（OR，1.02；95%可信区间，1 - 1.04；P =.034对OR，1.03；95%可信区间，1.01 - 1.05；P <.0001）。糖尿病降低了女性和男性患者的死亡几率（OR，0.68；95%可信区间，0.47 - 0.99；P =.046对OR，0.54；95%可信区间，0.41 - 0.7；P <.0001）。