Predicting postoperative course in Fournier's gangrene surgery: evaluation of the E-PASS score in a single-center retrospective study.

BACKGROUND: The E-PASS scoring system, which incorporates preoperative data and surgical stress factors, may provide a reliable risk classification for predicting mortality risk in patients with Fournier's gangrene. This study aimed to investigate the value of the E-PASS score in predicting mortality in patients with Fournier's gangrene. METHODS: The study included 41 patients who were diagnosed with FG clinically and underwent surgery. Preoperative demographic and clinical data, laboratory values, FGSI, and E-PASS scores were recorded. The patients were divided into two groups: 8 (19.5%) patients who developed mortality and 33 (80.5%) patients who were discharged without mortality. Demographic, clinical, and laboratory data, as well as FGSI and E-PASS scores, were compared between the groups. RESULTS: In the mortality group, CRP, serum creatinine levels, FGSI, E-PASS PRS, and E-PASS CRS scores were observed to be significantly higher, while serum albumin and hematocrit levels were lower compared to the other group (respectively, p = 0.020, p = 0.001, p < 0.001, p < 0.001, p < 0.001, p = 0.001, p < 0.001). FGSI, E-PASS CRS, CRP, and serum albumin values were found to have diagnostic value in predicting mortality. The cut-off values were determined as 7.5 for FGSI, 0.55 for E-PASS CRS, 186.25 for CRP, and 2.92 for albumin. CONCLUSION: Our findings show that E-PASS can provide additional value to existing prognostic assessment methods in Fournier's gangrene. The preoperative E-PASS PRS component, used alongside FGSI, may contribute to early identification of high-risk patients, while the postoperative CRS may assist in risk-adjusted postoperative management planning.