Department of General Surgery, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey.
J Invest Surg. 2024 Dec;37(1):2432958. doi: 10.1080/08941939.2024.2432958. Epub 2024 Nov 26.
Fournier's gangrene (FG) is a polymicrobial-induced necrotizing fasciitis that affects the deep and superficial tissues of the perineal, perianal, scrotal, and genital regions. This study aimed to investigate the role of C-reactive protein (CRP)/lymphocyte and neutrophil/lymphocyte ratios, which are objective markers of inflammatory response, in predicting mortality in patients with FG.
Seventy-one patients who underwent surgery for FG between 2019 and 2023 were evaluated retrospectively. Demographic and clinical characteristics, laboratory results, the FG severity index (FGSI) score, and the CRP/lymphocyte and neutrophil/lymphocyte ratios were analyzed for the patient groups with and without in-hospital mortality.
The characteristics of the patients with and without mortality were compared. A total of 71 patients, 51 (71.8%) males and 20 (28.2%) females, were evaluated. Eight patients died during treatment. The median age was 67 (56-86) years in the mortality group and 58 (27-82) years in the non-mortality group. Statistically significant differences were observed between the two groups in terms of age, lymphocyte count, CRP/lymphocyte, neutrophil/lymphocyte, potassium, blood urea nitrogen, and FSGI. In the receiver operating characteristic analysis of the CRP/lymphocyte and neutrophil/lymphocyte ratios, the cutoff values were calculated as 183.3 and 19.93, respectively. By comparing the data between the mortality and non-mortality groups, the sensitivity and specificity rates of these ratios were also determined.
The CRP/lymphocyte and neutrophil/lymphocyte ratios may be important parameters in predicting mortality in patients with FG.
Fournier 坏疽（FG）是一种多微生物诱导的坏死性筋膜炎，影响会阴、肛门周围、阴囊和生殖器区域的深层和浅层组织。本研究旨在探讨 C 反应蛋白（CRP）/淋巴细胞和中性粒细胞/淋巴细胞比值这两个炎症反应的客观标志物在预测 FG 患者死亡率中的作用。
回顾性评估了 2019 年至 2023 年间接受 FG 手术的 71 例患者。分析了患者的人口统计学和临床特征、实验室结果、FG 严重指数（FGSI）评分以及 CRP/淋巴细胞和中性粒细胞/淋巴细胞比值，比较了住院期间死亡和未死亡患者的特征。
比较了有和无死亡患者的特征。共有 71 例患者，51 例（71.8%）为男性，20 例（28.2%）为女性，8 例患者在治疗过程中死亡。死亡率组的中位年龄为 67（56-86）岁，非死亡率组为 58（27-82）岁。两组在年龄、淋巴细胞计数、CRP/淋巴细胞、中性粒细胞/淋巴细胞、钾、血尿素氮和 FGSI 方面存在统计学显著差异。在 CRP/淋巴细胞和中性粒细胞/淋巴细胞比值的受试者工作特征分析中，分别计算出截断值为 183.3 和 19.93。通过比较死亡率和非死亡率组的数据，还确定了这些比值的敏感性和特异性。
CRP/淋巴细胞和中性粒细胞/淋巴细胞比值可能是预测 FG 患者死亡率的重要参数。
