Importance of emergency department waiting period in Fournier's Gangrene; 10 years of experience

Abstract

Background Fournier's gangrene (FG) is a disease with high mortality rate. The first diagnosis is performed in the emergency department (ED). In this study, we investigated the importance of the time period for diagnosis in the ED. Methods The data of patients who were treated for FG between 1 January 2010 and 2020 were retrospectively analysed. Waiting period of the patients in ED was calculated. Risk factor score calculations were calculated to predict FG mortality and prognosis. The effects of the ED waiting period on the duration of admission to the hospital, the number of debridements and mortality status and relationship with FG mortality risk factor scores were investigated. Results In a 10-year period, a total of 66 patients were included in the study. It was found that the median age of the patients was 56 years. ED waiting period median (IQR) was 105 (115) minutes. It was observed that there was a significant positive correlation between the ED waiting period, duration of admission to hospital (rs: 0.537, P < .001) and patients mortality status (rs: 0.482, P < .001). The ED waiting period was higher in patients with FG mortality. It was observed that the ED waiting period holds a diagnostic value in predicting mortality (P < .001). The cut-off limit predicted for this value was determined as 136 minutes. Conclusion FG is a urological emergency. ED waiting period affects mortality rate and length of hospital stay. The earlier the diagnosis and treatment is conducted in the ED, the lower the mortality rate and length of stay in the hospital will be.