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Research Paper | Urology | India | Volume 12 Issue 10, October 2023 | Popularity: 5.2 / 10

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CUPI Score: A Novel Scoring System for Predicting the Hospital Stay in Patients with Fourniers Gangrene

Manjunath S B, Manohar C S

Abstract: Introduction & Objectives: Fournier?s gangrene is a rapidly progressive necrotizing fasciitis of the genital, perineal and perianal regions caused by bacterial infection with a much lower mortality rate of approximately 10% or less in the recent times. Subsequent survivors require lengthy hospital stays including pelvic debridement and the need for reconstruction. Therefore, the focus of Fournier?s management is shifting from preventing mortality to reducing morbidity, resource utilization and length of hospital stay. The aim of this study is to identify patient factors associated with hospital length of stay and to use these factors to create a novel scoring system that can accurately predict length of stay at the time of admission. Through the use of such a scoring system, patients requiring more extensive hospital management can be identified. Consequently, resources will be better allocated to patients based on a systematic assessment of healthcare needs, with the goal of improving patient outcomes and reducing hospital costs. Materials & methods: It is a retrospective study, data obtained from medical records. Inclusion criteria were a diagnosis of Fournier?s gangrene and having undergone surgical debridement during hospital stay. Patients with superficial abscesses were excluded. Predictors of LOS, morbidity, mortality and resource utilization were identified and univariate linear regressions performed to determine significance. The Combined Urology and Plastics Index ( CUPI ) score was then compared to existing scoring systems ( FGSI,NRC,CCI ) for predicting length of stay. Results & Observations: The mean patient age was 52.2, and the mean BMI was 32.3 Patients on average were hospitalized for 15.4 days with mean of 4.1 days in the ICU. Multivariate logistic modelling showed that BMI (p = 0.001) and alkaline phosphatase (p < 0.05) correlated with decreasing length of stay, while age at admission was not significantly correlated (p = 0.369). CUPI score was shown to be a significant predictor of longer hospital stays (p = 0.032). Conclusions: The CUPI scoring system helps to predict length of stay in patients with Fournier?s gangrene, and may help increasing care to at-risk patients. Multi-disciplinary care, aggressive nutrition and operative intervention all contribute to successful treatment for Fournier?s gangrene with lower mortality rates.

Keywords: Fournier's gangrene; genitalia; mortality; prognosis; risk factors

Edition: Volume 12 Issue 10, October 2023

Pages: 437 - 439

DOI: https://www.doi.org/10.21275/SR231004184542

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