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

Q: What was the main purpose of evaluating the qSOFA score in this study?

To assess how well the qSOFA score estimates mortality risk in Fournier’s gangrene patients and to enable a simple early decision-making tool.

Q: How were patients grouped for analysis?

Patients were divided into Group 1 (qSOFA 0–1) and Group 2 (qSOFA ≥2).

Q: What did the results show about mortality prediction?

A qSOFA score ≥2 was associated with higher mortality, and multivariate analysis confirmed it as an independent predictor with an odds ratio of 3.00.

Sep 30, 2026

Uploaded by ahduag

This retrospective study evaluated whether the quick Sequential Organ Failure Assessment (qSOFA) score predicts mortality in patients with Fournier’s gangrene treated with emergency surgery and aimed to support early bedside risk stratification. Patients undergoing emergency debridement between 2022 and 2024 were grouped as qSOFA 0–1 (Group 1) versus qSOFA ≥2 (Group 2). Mortality, hospital stay, clinical parameters, laboratory markers, and Fournier’s Gangrene Severity Index (FGSI) were analyzed using univariate and multivariate logistic regression.

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ORIGINAL ARTICLE The utility of the quick sequential organ failure assessment (qSOFA) score in predicting mortality in Fournier’s gangrene patients undergoing emergency surgery Adem Sancı, Hüseyin Mert Durak, Berk Yasin Ekenci, Ahmet Emin Doğan, Metin Yığman, Kubilay Sarıkaya, Azmi Levent Sağnak, Ahmet Nihat Karakoyunlu Department of Urology, Etlik City Hospital, Ankara-Türkiye 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 mortalityrelated factors. A qSOFA score ≥2 was significantly associated with higher mortality (p<0.05), and multivariate analysis confirmed it asan 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. Keywords: Fournier's gangrene; qSOFA score; mortality prediction; sepsis; prognostic tool. INTRODUCTION Fournier's gangrene (FG) is a life-threatening type of necrotizing fasciitis that primarily affects the perineum, genitalia, and surrounding tissues.[1] Although FG is a rapidly progressing and life-threatening infection, recent advances in diagnostic tools, treatment modalities, and clinical experience have significantly reduced its mortality rates. Current literature reports mortality rates of approximately 10-20%.[2-5] FG commonly occurs inpatients with underlying risk factors such as diabetes mellitus, immunosuppression, chronic kidney disease, and alcoholism.[6-7] Early diagnosis and treatment, including surgical debridement, intravenous antibiotics, and intensive care support, are essential for improving survival outcomes.[8] However, the rapid progression of the disease poses challenges for timely risk assessment and prognosis. Clinicians have used Fournier's Gangrene Severity Index (FGSI) to evaluate disease severity and predict mortality.[9] Although FGSI has demonstrated clinical utility, it requires multiple labo- Cite this article as: Sancı A, Durak HM, Ekenci BY, DoğanAE, Yığman M. The utility of the quick sequential organ failure assessment (qSOFA) score in predicting mortality in Fournier’s gangrene patients undergoing emergency surgery. Ulus Travma Acil Cerrahi Derg 2025;31:944-950. Address for correspondence: Adem Sancı Department of Urology, Etlik City Hospital, Ankara, Türkiye E-mail: [dr.adem88@hotmail.com](dr.adem88@hotmail.com) Ulus Travma Acil Cerrahi Derg 2025;31(10):944-950 DOI: 10.14744/tjtes.2025.63576 Submitted: 06.07.2025 Revised: 12.08.2025 Accepted: 05.09.2025 Published: 07.10.2025 OPEN ACCESS This is an open access article under the CC BY-NC license ([http://creativecommons.org/licenses/by-nc/4.0/](http://creativecommons.org/licenses/by-nc/4.0/)). 944 Ulus Travma Acil Cerrahi Derg, October 2025, V

FAQs

What was the main purpose of evaluating the qSOFA score in this study?

To assess how well the qSOFA score estimates mortality risk in Fournier’s gangrene patients and to enable a simple early decision-making tool.

How were patients grouped for analysis?

Patients were divided into Group 1 (qSOFA 0–1) and Group 2 (qSOFA ≥2).

What did the results show about mortality prediction?

A qSOFA score ≥2 was associated with higher mortality, and multivariate analysis confirmed it as an independent predictor with an odds ratio of 3.00.

Sep 30, 2026

Uploaded by ahduag