A new tool to predict mortality in Fournier's Gangrene: Controlling Nutritional Status (CONUT) score

The aim of our study was to demonstrate the role of The Controlling Nutritional Status (CONUT) score in predicting mortality after Fournier's Gangrene (FG) debridement by comparing it with other scoring systems.

Data of 193 patients who underwent debridement for FG between January 2013 and December 2024 were retrospectively analyzed. Survivor 156 patients (Group S) and 37 non-survivor patients (Group NS) were divided into two groups. Four scoring systems commonly used to predict mortality in FG and the CONUT score were compared by regression analyses. Cut-off values were determined for each scoring system and ROC curves were constructed.

Mortality rate was 19.2%. Total CONUT and other scoring systems were higher in Group NS (p < 0.001). In multivariate analyses, an increase in Total CONUT score predicted mortality (OR = 99.26; 95% CI 8.19-120.30: p < 0.001). The sensitivity, specificity, PPV, NPV and AUC values at the CONUT score ≥ 2.5 cut-off were 86%, 87%, 87%, 87%, 96% and 0.935 (95% CI: 0.88-0.98; p < 0.001), respectively.

The CONUT score predicts mortality in FG with high sensitivity and specificity. It is also easy and practical to calculate.