Comparison of FGSI and HALP scores for mortality prediction in Fournier's Gangrene: A retrospective analysis

This study aimed to compare the prognostic performance of the Fournier's Gangrene Severity Index (FGSI) and the hemoglobin-albumin-lymphocyte-platelet (HALP) score in predicting in-hospital mortality among patients diagnosed with Fournier's gangrene. As Fournier's gangrene remains a life-threatening and rapidly progressive soft tissue infection, early risk stratification is critical for improving patient outcomes. Validating practical scoring systems may support timely clinical decision-making and resource allocation.

A retrospective analysis was performed on 52 patients who underwent surgical treatment for Fournier's gangrene at a tertiary referral center between December 2022 and June 2025. Demographic, laboratory, and clinical data were collected, and both FGSI and HALP scores were calculated at the time of admission. Receiver Operating Characteristic (ROC) curve analysis and multivariate logistic regression were used to assess the predictive value of both scores for in-hospital mortality.

The mean FGSI was 5.1±2.2, while the mean HALP score was 134.6±100.2. FGSI showed acceptable discrimination (AUC=0.7639; cutoff=5.0), with 72.7% sensitivity and 67.7% specificity. HALP had poor predictive ability (AUC=0.4018). In multivariate analysis, FGSI was an independent predictor (p=0.0146), while HALP was not (p=0.9474).

FGSI appears to be a reliable and independent prognostic tool in patients with Fournier's gangrene. HALP, however, does not offer additional prognostic benefit. FGSI should be prioritized in early risk assessment to guide management strategies.