USE OF MEAN PLATELET VOLUME, RED BLOOD CELL DISTRIBUTION WIDTH, NEUTROPHIL-TO-LYMPHOCYTE RATIO AND THE PLATELET-TO-LYMPHOCYTE RATIO AS INDICATORS OF PROGNOSIS IN FOURNIER'S GANGRENE

Abstract

Introduction: Several scales have been developed to predict the prognosis of Fournier gangrene (FG); however, no consensus exists regarding the optimal approach. This study investigated the applicability of several commonly measure blood parameters [mean plate-let volume (MPV), red blood cell distribution width (RDW), the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR)] as predictive tools for FG prognosis. Materials and methods: This study was retrospectively conducted using the patient files from the general surgery clinic of a public university hospital in Turkey between January 2009 and January 2017. The chosen blood parameters (MPV, RDW, NLR and PLR) were separately determined at the time of admission, during treatment and after treatment. The changes in the parameters were analyzed to see if they could be used as predictors for the prognosis of FG. Results: A total of 33 patients were included in the study [12 females (36.4%) and 21 males (63 .6%)). Twenty-four (72.7%) patients recovered, and nine (273%) died. Female gender and being admitted to the intensive care unit were associated with mortality (p = 0.044, p = 0.001). A logistic regression analysis revealed that the risk of FG-related mortality was 931 times higher among women than men. NLR levels decreased significantly in patients who recovered, and NLR level > 0.91 was associated with a 40.583-fold higher risk of mortality. MPV levels were not useful as a marker of the severity or extent of disease (p = 0.012). Conclusion: NLR is an independent predictor of mortality in patients with FG. MPV had no prognostic value. Further multicenter studies with larger samples are required to confirm these findings.