Volumetric computed tomography measurements as predictors for outcomes in a cohort of Fournier's gangrene patients.

Autor: Ganapathy A; School of Medicine, Washington University in St. Louis, St. Louis, MO, 63110, USA., Ballard DH; Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd; Campus Box 8131, St. Louis, MO, 63110, USA. davidballard@wustl.edu., Garuba F; School of Medicine, Washington University in St. Louis, St. Louis, MO, 63110, USA., Lovato A; Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd; Campus Box 8131, St. Louis, MO, 63110, USA., Mazaheri P; Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd; Campus Box 8131, St. Louis, MO, 63110, USA., Chen DZ; School of Medicine, Washington University in St. Louis, St. Louis, MO, 63110, USA., Schneider M; School of Medicine, Washington University in St. Louis, St. Louis, MO, 63110, USA., Lanier MH; Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd; Campus Box 8131, St. Louis, MO, 63110, USA., Ilahi O; Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA., Kirby JP; Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA., Raptis CA; School of Medicine, Washington University in St. Louis, St. Louis, MO, 63110, USA., Mellnick VM; Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd; Campus Box 8131, St. Louis, MO, 63110, USA.
Jazyk: angličtina
Zdroj: Emergency radiology [Emerg Radiol] 2024 Aug; Vol. 31 (4), pp. 481-489. Date of Electronic Publication: 2024 Jun 06.
DOI: 10.1007/s10140-024-02251-z
Abstrakt: Purpose: This study evaluates the prognostic value of CT findings, including volumetric measurements, in predicting outcomes for patients with Fournier gangrene (FG), focusing on mortality, ICU admission, hospital stay length, and healthcare costs.
Methods: A retrospective study was conducted on 38 FG patients who underwent CT scans before surgical debridement. We analyzed demographic data, CT volumetric measurements, and clinical outcomes using logistic and linear regression models.
Results: No single CT measurement significantly predicted mortality or ICU admission. The best model for mortality prediction included age, air volume, NSTI score, and male sex, with an AUC of 0.911. Intubation likelihood was modeled with an AUC of 0.913 using age, NSTI score, and visceral to subcutaneous fat ratio. The ICU admission model achieved an AUC of 0.677. Hospital stay was predicted by air volume (β = 0.0002656, p = 0.0505) with an adjusted R-squared of 0.1287. Air volume significantly predicted hospital costs (β = 2.859, p = 0.00558), resulting in an adjusted R-squared of 0.2165.
Conclusion: Volumetric CT findings provide valuable prognostic insights for FG patients, suggesting a basis for informed clinical decisions and resource allocation. Further validation in larger, multi-center studies is recommended to develop robust predictive models for FG outcomes.
(© 2024. The Author(s), under exclusive licence to American Society of Emergency Radiology (ASER).)
Databáze: MEDLINE
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