The utility of the quick sequential organ failure assessment (qSOFA) score in predicting mortality in Fournier's gangrene patients undergoing emergency surgery

快速序贯器官衰竭评估(qSOFA)评分在预测接受急诊手术的坏疽性筋膜炎患者死亡率中的应用价值

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Abstract

BACKGROUND: This study aimed to evaluate the predictive value of the quick Sequential Organ Failure Assessment (qSOFA) score in estimating mortality risk in Fournier's gangrene patients and to provide a simple tool for early clinical decision-making. METHODS: This retrospective study included patients who underwent emergency debridement for Fournier's gangrene between 2022 and 2024. Patients with systemic involvement of the perianal and inguinal canal were included. Clinical parameters, laboratory markers, Fournier's Gangrene Severity Index (FGSI) scores, and outcomes such as mortality and hospital stay were analyzed. Patients were categorized into two groups: Group 1 (qSOFA 0-1) and Group 2 (qSOFA ≥2). Univariate and multivariate logistic regression analyses were performed to identify independent predictors of mortality. RESULTS: Among 89 patients, 55 were in Group 1 and 34 in Group 2. The overall mortality rate was 21.35% (Group 1: 12.73%, Group 2: 35.29%, p<0.05). Significant differences were observed between groups in age, comorbidities, respiratory rate, procalcitonin, FGSI scores, and hospital stay (all p<0.05). Univariate analysis identified age, FGSI score, comorbidities, and procalcitonin as mortality-related factors. A qSOFA score ≥2 was significantly associated with higher mortality (p<0.05), and multivariate analysis confirmed it as an independent predictor (odds ratio: 3.00, p<0.05). CONCLUSION: The qSOFA score is a simple and reliable predictor of mortality in Fournier's gangrene, supporting its use for early risk assessment and timely clinical interventions.

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