ArticleBMC surgery2026
The role of prognostic scoring systems in determining mortality and morbidity in patients with Fournier's gangrene.
Article in BMC surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundFournier’s gangrene (FG) is a rare but severe form of necrotizing fasciitis characterized by high mortality and morbidity rates. In this study, the predictive power of the classical Fournier’s Gangrene Severity Index (FGSI) was compared with new hematological-inflammatory and nutritional scoring systems, including the Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score, Global Immune-Nutrition-Inflammation Index (GINI), and Prognostic Nutritional Index (PNI), in predicting the prognosis of FG. MATERIALS AND
methodsThis retrospective cohort study included the clinical and laboratory data of 108 patients diagnosed with Fournier’s gangrene (FG) and treated at Antalya Training and Research Hospital between 2019 and 2024. Based on these data, FGSI, HALP, GINI, and PNI scores were calculated, and their associations with prognosis were analyzed.
resultsThe mortality rate was found to be 17.6%, and the median hospital stay was 23.5 days. On group comparison, FGSI was higher in the mortality group (p = 0.003) and PNI was lower (p = 0.021), whereas HALP, IBI, and GINI did not differ significantly. In logistic regression, advanced age, low albumin, and low platelet count were independent predictors of mortality. For prolonged hospitalization (≥ 20 days), ROC analyses showed significant associations for FGSI (AUC 0.608; p = 0.048), HALP (AUC 0.616; p = 0.041), and GINI (AUC 0.620; p = 0.031), while IBI and PNI were not significant.
conclusionSystemic inflammation and nutritional status play a significant role in the prognosis of FG. FGSI remains the most robust scoring system in predicting mortality. While the new indices have potential in predicting morbidity, there is a need for comprehensive prospective studies to validate these findings.
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