MP37-20: Outcomes and health-related quality of life (HRQoL) in long-term survivors of Fournier's gangrene

Laila Schneidewind*, Vanessa Roßberg, Desiree L. Dräger, Rostock, Germany, Joachim Steffens, Eschweiler, Germany, Oliver W. Hakenberg, Rostock, Germany, Jennifer Kranz, Aachen, Germany

Introduction: Fournier's gangrene (FG) is a sporadic, life-threatening, necrotizing infection affecting the perineum, perineal region and genitals. Unfortunately, FG has a poor prognosis, which has not improved in recent years. As the incidence is low, data about outcomes and quality of life in long-term survivors of FG are lacking. Consequently, we performed a multicentric study with the primary aim to describe health-related quality of life (HRQoL).

Methods: We retrospectively identified male patients treated for FG via ICD-10 coding in two centers (one university medical center and one tertiary care center) from January 2010 to December 2020 (ten years). Patients who survived the inhouse treatment were invited to participate in a survey including the validated questionnaires International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF-5), Quality of Life in chronic wounds (WOUND-QoL), Freiburger Life Quality Assessment – wound module (FLQA-w) and the Short Form Health (SF-36).

Results: Finally, 39 patients with a median age of 65.0 years (IQR 53.0 – 74.0) at therapy for FG were identified. Twenty patients were already dead (51.3%), nine patients were lost to follow up (23.1%), and ten patients participated in the survey (25.6%). The median survival time was 27.0 months (IQR 9.0 – 60.0). In eight patients (one of the ten had a suprapubic catheter and one practiced self-catheterization) the median IPSS was 13.5 (IQR 4.3 – 22.3), five patients (50.0%) had severe erectile dysfunction. On the whole, three patients (30.0 %) reported problems with the wound, two (20.0%) complained about wound pain and one (10.0%) about the wound healing situation. The mean global health score in WOUND-QoL was 1.83 (SD 1.1), which is significantly less than in the German reference population (p < 0.0001). In the FLQA-w the mean subscales were for physical aliment 1.8 (SD 1.1), everyday life 1.5 (Sd 0.5), social life 1.6 (SD 0.8), psychological well-being 1.8 (SD 1.2) and satisfaction in different areas of life 1.9 (SD 1.0), respectively. The mean general health score in SF-36 was 64.0 (SD 10.5). Interestingly, age over 70 years is not significantly associated with worse reported outcomes in all subscales of used questionnaires.

Conclusions: In long-term survivors of FG the wound situation has a deeply negative impact on HRQoL. This impact seems not to be age-dependent. Further research is essential to ensure the quality of care.

Source of Funding: Institutional