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Prognostic Indices for Mortality Prediction in Fournier's Gangrene: A Comparative Study Introducing PCT-ALLY
M Sesli1, M Başaranoğlu2, A A Özdeş3
1Urology Department, Malatya Education and Research Hospital, Malatya, Turkey.
Nigerian Journal of Clinical Practice
|August 10, 2026
Summary
New immuno-nutritional indices, CALLY and PCT-ALLY, effectively predict mortality in Fournier
Area of Science:
- Medical research
- Surgical oncology
- Critical care medicine
Background:
- Fournier's gangrene is a severe necrotizing fasciitis with high mortality rates (20%-50%).
- Effective prognostic tools for early risk stratification in Fournier's gangrene are limited.
- Routine laboratory tests are crucial for developing practical prognostic indicators.
Purpose of the Study:
- To compare the efficacy of seven established prognostic indices in predicting Fournier's gangrene mortality.
- To develop and validate a novel procalcitonin-based index (PCT-ALLY) for mortality prediction.
- To assess the predictive performance of immuno-nutritional indices.
Main Methods:
- Retrospective cohort study of 220 surgically treated Fournier's gangrene patients.
- Calculation of multiple preoperative laboratory-based indices including NLR, HALP, SIRI, CALLY, and PCT-ALLY.
- Assessment of mortality prediction using ROC analysis and multivariable logistic regression.
Main Results:
- Overall mortality rate was 30% (66/220 patients).
- CALLY demonstrated the highest AUC (0.935), followed by PCT-ALLY (0.874).
- CALLY, HALP, and PCT-ALLY were identified as independent predictors of mortality in multivariable analysis.
Conclusions:
- Immuno-nutritional indices, specifically CALLY and PCT-ALLY, offer robust, cost-effective mortality prediction for Fournier's gangrene.
- These indices can aid in early risk stratification of high-risk patients.
- Further prospective multicenter validation of PCT-ALLY and CALLY is recommended.