2016/01/01 by Mathew D. Sorensen, John N. Krieger · 204 citations
Medicine · #Appendicitis Diagnosis and Management #Case fatality rate #Emergency medicine #Epidemiology #Family medicine #Fasciitis #Fournier gangrene #Gangrene #Incidence (geometry) #Internal medicine #Medicine #Mortality rate #Necrotising fasciitis #Otolaryngology and Infectious Diseases #Pediatrics #Population #Referral #Streptococcal Infections and Treatments #Surgery
paper · pdf · doi:10.1159/000445695
published in Urologia Internationalis 97(3), 249-259 (Karger Publishers)
crossref issued 2016/01/01 · crossref published 2016/01/01 · crossref published-print 2016/01/01 · openalex publication_date 2016/01/01 · crossref created 2016/05/13 · crossref published-online 2016/05/14 · crossref deposited 2025/04/23 · openalex created_date 2025/10/10 · crossref indexed 2026/07/31 · openalex updated_date 2026/07/31
PURPOSE: Case series reported 20-40% mortality rates for patients with Fournier's gangrene with some series as high as 88%. This literature comes almost exclusively from referral centers. MATERIALS AND METHODS: We identified and analyzed inpatients with Fournier's gangrene who had a surgical debridement or died in the US State Inpatient Databases. RESULTS: One thousand six hundred and forty one males and 39 females with Fournier's gangrene represented <0.02% of hospital admissions. Overall, the incidence was 1.6 cases per 100,000 males and case fatality was 7.5%. Sixty six percent of hospitals cared for no cases per year, 17% cared for 1 case per year, 10% cared for 2 cases per year, 4% cared for 3 cases per year, 1% cared for 4 cases per year, and only 1% cared for ≥5 cases per year. Teaching hospitals had higher mortality (adjusted OR 1.9) due primarily to more acutely ill patients. Hospitals treating more than 1 Fournier's gangrene case per year had an adjusted 42-84% lower mortality (p < 0.0001). CONCLUSIONS: Most hospitals rarely care for Fournier's gangrene patients. The population-based mortality rate (7.5%) was substantially lower than the case series from tertiary care centers. Hospitals that treated more number of Fournier's gangrene patients had lower mortality rates, thereby supporting the rationale that regionalized care worked well for patients with this rare disease.