Podium 1
Fournier’s gangrene在不同年齡的臨床表現和風險因子
徐任廷1、鐘旭東1、歐正峰1
1亞東紀念醫院 外科部 泌尿科
Age-Related Differences in Risk Factors and Clinical Presentations of Fournier's Gangrene
Jen-Ting Hsu1, Shiu-Dong Chung1, Chin fong Au1
Division of Urology1 Department of Surgery, Far Eastern Memorial Hospital, New Taipei City
Introduction & Objectives
Fournier's gangrene refers to necrotizing fasciitis involving the genital, perineal, and perineal tissues. Although it is more commonly associated with older individuals due to their relatively higher susceptibility resulting from immunocompromised status, we have still observed cases in younger patients. We aim to investigate the risk factors and clinical presentations that may induce the disease within different age groups to better understand Fournier's gangrene.
Materials & Methods
Clinical data from 105 patients diagnosed with Fournier's gangrene at our hospital from 2006 to 2023 were analyzed. The patients were divided into two age groups: those under 45 and those 45 and above. Risk factors, clinical presentation, mortality rates, and hospital stays were compared between these groups. Bacterial species causing infections were also examined in both age groups.
Results
The group aged below 45 consisted of 27 patients, while the group aged 45 and above had 78 patients. There was no statistically significant difference in Fournier’s Gangrene Severity Index(FGSI) between the two groups. The younger group had a statistically significantly higher average BMI (30.2, SD=9.4) compared to the older group (26.8, SD=6.6). (p=0.047). Regarding risk factors, hypertension, cerebral vascular accident, and coronary artery disease were more prevalent in the older age group, while diabetes mellitus, chronic kidney disease, hyperlipidemia and symptom-to-admission days showed no significant differences. Mortality rates(age< 45 group=0% vs age>= 45 group= 16.7%, p=0.023) and length of hospital stay(age< 45 group=17.6 days vs age>= 45 group= 25.0 days, p=0.011) were both higher in the group aged over 45. In terms of bacterial strains, there was no significant distinction between the two groups, with Escherichia coli, Klebsiella pneumoniae, and Enterococcus species being predominant in both.
Conclusions
While Fournier's gangrene is more commonly observed in individuals aged 50 and above, it also occurs in a proportion of younger populations. A relatively higher BMI is the primary risk factor for Fournier's gangrene in the younger age group. The most common predisposing factor, diabetes mellitus, shows no significant difference between the two age groups. The younger age group exhibits lower hospitalization days and mortality rates compared to the older group, and there are similar bacterial strain profiles between the two groups.