7% M, p = 0 0011) [18] We could not confirm this result, as fema

7% M, p = 0.0011) [18]. We could not confirm this result, as female gender did not appear as predictor factor https://www.selleckchem.com/products/bay-11-7082-bay-11-7821.html of mortality in our study (Table 4). Numerous factors have been implicated at the onset of FG, in particular, those

involving the immune system [19–22]. Diabetes mellitus was the most selleck kinase inhibitor reported co-morbid disease associated with this pathology. Some authors estimate the prevalence of DM among FG patients between 50 and 70 percent [23–25]. Despite of being a risk factor for FG and associated with a more progressive and fatal outcome (decreased phagocytic and intracellular bactericidal activity and neutrophil dysfunction), most reported studies along with our have failed to demonstrate the influence of DM on outcomes in FG [26–28]. It is also suggested that renal failure on admission might be a noticeable factor for the prediction of the mortality rate [8, 29]. Among many laboratory parameters studied in FG, Clayton et al., reported that only a level of blood urea >0.5 g/l on admission was statistically significant for mortality [30]. In our study we also found that renal failure on admission is significantly higher in non survivors. Few CAL-101 supplier articles have highlighted the poor prognosis of FG in patients with a delay between time of presentation and treatment. This factor has been reported in a study by Jeong et al., as a predictor of mortality [6]. Along with other studies, we did not find delay this to be a major predictor of mortality

[31, 32]. The extension of the disease and the mortality rate are controversial themes in the literature. Some studies have reported that the spread of the disease is related to a higher death rate, while other studies report that the extension of the gangrene does not relate to a poorer prognosis [30, 33].

In this field, extent to abdominal wall (Figure 1) has been reported to be directly related to mortality [22, 34, 35], which was confirmed in our series. Ultimately, occurrence of septic shock and need for postoperative mechanical ventilation, have been demonstrated as a powerful (even late) Cediranib (AZD2171) factors of mortality [8, 9, 24, 36]. Furthermore, Yanar et al. found that the presence of sepsis was as the only significant independent risk factor for mortality in FG [3]. Our results join those reported in literature, although in multivariate analysis, these parameters have been not identified as independent predictors of mortality. Finally we acknowledge that our study has important limitations. Data collection was retrospective, the patient cohort is small, we focused on some variables but surely dismiss others not less important, we did not have access to important clinical and laboratory data so that we could not use and evaluate the performance of the Fournier’s Gangrene Severity Index. Table 4 Mortality among male and female in different series Series Number of cases Male Female p Jarboui et al., 2007 [24] 35 24% 25% <0.05 Cyzmek et al., 2010 [18] 51 7,7% 50% 0.

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