TY - CHAP T1 - Fournier’s gangrene: population-based epidemiology and outcomes T2 - Urogenital Infections and Inflammations AU - Sorensen, Mathew AU - Krieger, John N. ED - Naber, Kurt G. AD - Mathew Sorensen, University of Washington School of Medicine, Department of Urology, 1959 NE Pacific Street, Box 356510, 98195, Seattle, United States, Phone: 206-685-1982, E-mail: mathews@uw.edu N2 - Purpose: Case series reported 20–40% mortality rates for patients with Fournier’s gangrene with some series as high as 88%. This literature comes almost exclusively from referral centers. Materials and Methods: We identified and analyzed inpatients with Fournier’s gangrene who had a surgical debridement or died in the US State Inpatient Databases. Results: 1,641 males and 39 females with Fournier’s gangrene represented <0.02% of hospital admissions. Overall, the incidence was 1.6 cases per 100,000 males and case fatality was 7.5%. 66% of hospitals cared for no cases per year, 17% cared for 1 case per year, 10% cared for 2 cases per year, 4% cared for 3 cases per year, 1% cared for 4 cases per year, and only 1% cared for ≥5 cases per year. Teaching hospitals had higher mortality (aOR 1.9) due primarily to more acutely ill patients. Hospitals treating more than 1 Fournier’s gangrene case per year had an adjusted 42–84% lower mortality (p<0.0001). Conclusions: Most hospitals rarely care for Fournier’s gangrene patients. The population-based mortality rate (7.5%) was substantially lower than case series from tertiary care centers. Hospitals that treated more Fournier’s gangrene patients had lower mortality rates supporting the rationale for regionalized care for patients with this rare disease. PY - 2018 DA - 2018/09/03 DO - 10.5680/lhuii000038 LA - en UR - https://dx.doi.org/10.5680/lhuii000038 L2 - https://dx.doi.org/10.5680/lhuii000038 KW - Fournier’s gangrene KW - mortality KW - necrotizing infection KW - epidemiology KW - outcomes KW - management PB - German Medical Science GMS Publishing House CY - Berlin ER -