一种预测福尼尔坏疽死亡率的新工具：控制营养状况（CONUT）评分。
A new tool to predict mortality in Fournier's Gangrene: Controlling Nutritional Status (CONUT) score.
作者信息
Ayten Ali, Gelmis Mucahit, Kınık Abdullah Harun, Ozlu Deniz Noyan, Kose Mustafa Gokhan
机构信息
Department of Urology, Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey.
Department of Urology, Bitlis State Hospital, Bitlis, Turkey.
出版信息
World J Urol. 2025 May 6;43(1):277. doi: 10.1007/s00345-025-05635-z.
PURPOSE
The aim of our study was to demonstrate the role of The Controlling Nutritional Status (CONUT) score in predicting mortality after Fournier's Gangrene (FG) debridement by comparing it with other scoring systems.
METHODS
Data of 193 patients who underwent debridement for FG between January 2013 and December 2024 were retrospectively analyzed. Survivor 156 patients (Group S) and 37 non-survivor patients (Group NS) were divided into two groups. Four scoring systems commonly used to predict mortality in FG and the CONUT score were compared by regression analyses. Cut-off values were determined for each scoring system and ROC curves were constructed.
RESULTS
Mortality rate was 19.2%. Total CONUT and other scoring systems were higher in Group NS (p < 0.001). In multivariate analyses, an increase in Total CONUT score predicted mortality (OR = 99.26; 95% CI 8.19-120.30: p < 0.001). The sensitivity, specificity, PPV, NPV and AUC values at the CONUT score ≥ 2.5 cut-off were 86%, 87%, 87%, 87%, 96% and 0.935 (95% CI: 0.88-0.98; p < 0.001), respectively.
CONCLUSION
The CONUT score predicts mortality in FG with high sensitivity and specificity. It is also easy and practical to calculate.
目的
我们研究的目的是通过将控制营养状况（CONUT）评分与其他评分系统进行比较，来证明其在预测福尼尔坏疽（FG）清创术后死亡率方面的作用。
方法
回顾性分析了2013年1月至2024年12月期间193例接受FG清创术患者的数据。156例存活患者（S组）和37例非存活患者（NS组）被分为两组。通过回归分析比较了FG中常用的四种预测死亡率的评分系统和CONUT评分。确定了每个评分系统的临界值并构建了ROC曲线。
结果
死亡率为19.2%。NS组的总CONUT评分和其他评分系统更高（p<0.001）。在多变量分析中，总CONUT评分的增加可预测死亡率（OR=99.26；95%CI 8.19-120.30：p<0.001）。CONUT评分≥2.5临界值时的敏感性、特异性、阳性预测值、阴性预测值和AUC值分别为86%、87%、87%、87%、96%和0.935（95%CI：0.88-0.98；p<0.001）。
结论
CONUT评分对FG死亡率具有较高的敏感性和特异性，且计算简单实用。
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