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Background <p>Fournier’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.</p> Materials and methods <p>This 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.</p> Results <p>The 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 (<i>p</i> = 0.003) and PNI was lower (<i>p</i> = 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; <i>p</i> = 0.048), HALP (AUC 0.616; <i>p</i> = 0.041), and GINI (AUC 0.620; <i>p</i> = 0.031), while IBI and PNI were not significant.</p> Conclusion <p>Systemic 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.</p>

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The role of prognostic scoring systems in determining mortality and morbidity in patients with Fournier’s gangrene

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月23日

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  • Ömer Çelik,
  • Remzi Can Çakır,
  • Halit Özgül,
  • Turan Can Yıldız,
  • Ali Çelik,
  • Burak Şakar

摘要

Background

Fournier’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 methods

This 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.

Results

The 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.

Conclusion

Systemic 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.