使用台灣健保資料庫找出弗尼爾式壞疽死亡相關的危險因子
林宗彥1、陳奕宏1、蘇建州3、張育菁3、歐建慧2、鄭裕生2
1國立成功大學附設醫院斗六分院泌尿部、2國立成功大學附設醫院泌尿部、3國立成功大學醫學院藥理所
Identify risk factors of mortality in Fournier’s gangrene using Taiwan national health insurance research database
Tsung-Yen Lin1, I-Hung Cheng2, Chien-Chou Su3, Yu-Ching Chang3,Ou Chien-Hui1 Yu-Sheng Cheng1
1Division of Urology, Department of Surgery, National Cheng Kung University Hospital, Dou-Liou Branch, College of Medicine, National Cheng Kung University, Yunlin, and 2Department of Urology, Medical College and Hospital, National Cheng-Kung University, Tainan 3Institue of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Abstract
Purpose:
Fournier’s gangrene(FG) is known as the life-threatening disease with mortality rates ranging from 0 to 45%. In the past decades, numerous risk factors of mortality such as increasing age, diabetes, heart disease, renal failure, and coagulopathy were reported. The risk factors reported in different regions or countries are not exact the same. In this study, we aim to identify risk factors of mortality in Fournier’s gangrene in Taiwan using Taiwan national health insurance research database.
Materials and Methods:
From 2002 to 2016, the patients diagnosed with FG who received subsequent surgical intervention were enrolled from the National Health Research Institute Database of Taiwan. We collected the patients’ sequential clinical data. We used multiple variable and variable selection analysis for rate ratio of in-hospital mortality in patients with Fournier's gangrene.
Results:
Total of 2183 FG patients were enrolled in this study, with 7.97% mortality. The trendline of age-standardized incidence was almost flat with average 0.48 per 100000 population of annual age-standardized incidence. The mortality rate apparent increased with age. After multivariate analysis, the significant risk factors of mortality were age (RR=1.03), ulcer diseases (RR=1.42), mild liver disease (RR=1.70), moderate or severe liver disease (RR=3.18), renal disease (RR=1.82), tumor (RR=1.84).
Conclusions:
The mortality rate of inpatient FG was 7.97% in Taiwan. The risk factors of mortality in FG include age, ulcer diseases, liver disease, renal disease, and tumor.