{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:14:17Z","timestamp":1790054057820,"version":"4.0.1"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2023,8,14]],"date-time":"2023-08-14T00:00:00Z","timestamp":1691971200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,8,14]],"date-time":"2023-08-14T00:00:00Z","timestamp":1691971200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Urol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>To compare different scoring systems for predicting in-hospital mortality in patients with Fournier gangrene (FG).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A comprehensive literature search was performed to find all scoring systems that have been proposed previously as a predictor for in-hospital mortality in patients with FG. Data of all patients with FG who were hospitalized in one of Indonesia\u2019s largest tertiary referral hospitals between 2012 and 2022 were used. The receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance of the scoring systems.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Ten scoring systems were found, i.e., Fournier\u2019s Gangrene Severity Index (FGSI), Uludag FGSI, simplified FGSI, NUMUNE Fournier score (NFS), Laboratory Risk Indicator for Necrotizing Fasciitis, age-adjusted Charlson comorbidity index, sequential organ failure assessment (SOFA), quick SOFA, acute physiology and chronic health evaluation II, and surgery APGAR score (SAS). Of 164 FG patients included in the analyses, 26.4% died during hospitalization. All scoring systems except SAS could predict in-hospital mortality of patients with FG. Three scoring systems had areas under the ROC curve (AUROC) higher than 0.8, i.e., FGSI (AUROC 0.905, 95% confidence interval (CI) 0.860\u20130.950), SOFA (AUROC 0.830, 95% CI 0.815\u20130.921), and NFS (AUROC 0.823, 95% CI 0.739\u20130.906). Both FGSI and SOFA had sensitivity and NPV of 1.0, whereas NFS had a sensitivity of 0.74 and an NPV of 0.91.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This study shows that FGSI and SOFA are the most reliable scoring systems to predict in-hospital mortality in FG, as indicated by the high AUROC and perfect sensitivity and NPV.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00345-023-04552-3","type":"journal-article","created":{"date-parts":[[2023,8,14]],"date-time":"2023-08-14T20:04:16Z","timestamp":1692043456000},"page":"2751-2757","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Comparison of different scoring systems for predicting in-hospital mortality for patients with Fournier gangrene"],"prefix":"10.1007","volume":"41","author":[{"given":"Yufi Aulia","family":"Azmi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5628-1345","authenticated-orcid":false,"given":"Firas F.","family":"Alkaff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Renaldo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soetojo","family":"Wirjopranoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rinta","family":"Prasetiyanti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin Muliawan","family":"Soetanto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sovia","family":"Salamah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul Khairul Rizki","family":"Purba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten J.","family":"Postma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,8,14]]},"reference":[{"issue":"8","key":"4552_CR1","doi-asserted-by":"publisher","first-page":"1128","DOI":"10.14744\/tjtes.2021.97866","volume":"28","author":"Y Tosun","year":"2022","unstructured":"Tosun Y, Ak\u0131nc\u0131 O, K\u00fc\u00e7\u00fck HF (2022) Risk factors for mortality in Fournier\u2019s gangrene of anorectal origin. Ulusal Travma Acil Cerrahi Derg 28(8):1128\u20131133. https:\/\/doi.org\/10.14744\/tjtes.2021.97866","journal-title":"Ulusal Travma Acil Cerrahi Derg"},{"issue":"3","key":"4552_CR2","doi-asserted-by":"publisher","first-page":"746","DOI":"10.12669\/pjms.323.9798","volume":"32","author":"K Taken","year":"2016","unstructured":"Taken K, Oncu MR, Ergun M, Eryilmaz R, Demir CY, Demir M, Gunes M (2016) Fournier\u2019s gangrene: causes, presentation and survival of sixty-five patients. Pak J Med Sci 32(3):746\u2013750. https:\/\/doi.org\/10.12669\/pjms.323.9798","journal-title":"Pak J Med Sci"},{"issue":"3","key":"4552_CR3","doi-asserted-by":"publisher","first-page":"79","DOI":"10.15406\/unoaj.2014.01.00018","volume":"1","author":"A Saber","year":"2014","unstructured":"Saber A (2014) A simplified prognostic scoring system for Fournier\u2019s gangrene. Urol Nephrol Open Access J 1(3):79\u201382. https:\/\/doi.org\/10.15406\/unoaj.2014.01.00018","journal-title":"Urol Nephrol Open Access J"},{"issue":"2","key":"4552_CR4","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1016\/j.ajur.2021.11.003","volume":"10","author":"BS Noegroho","year":"2021","unstructured":"Noegroho BS, Adi K, Mustafa A, Haq RS, Wijayanti Z, Liarto J (2021) The role of quick sepsis-related organ failure assessment score as simple scoring system to predict Fournier gangrene mortality and the correlation with Fournier\u2019s gangrene severity index: analysis of 69 patients. Asian J Urol 10(2):201\u2013207. https:\/\/doi.org\/10.1016\/j.ajur.2021.11.003","journal-title":"Asian J Urol"},{"issue":"3","key":"4552_CR5","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1159\/000445695","volume":"97","author":"MD Sorensen","year":"2016","unstructured":"Sorensen MD, Krieger JN (2016) Fournier\u2019s gangrene: epidemiology and outcomes in the general US population. Urol Int 97(3):249\u2013259. https:\/\/doi.org\/10.1159\/000445695","journal-title":"Urol Int"},{"issue":"4","key":"4552_CR6","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1111\/bju.14998","volume":"125","author":"RS Radcliffe","year":"2020","unstructured":"Radcliffe RS, Khan MA (2020) Mortality associated with Fournier\u2019s gangrene remains unchanged over 25 years. BJU Int 125(4):610\u2013616. https:\/\/doi.org\/10.1111\/bju.14998","journal-title":"BJU Int"},{"issue":"3","key":"4552_CR7","doi-asserted-by":"publisher","first-page":"190","DOI":"10.5152\/tud.2016.14194","volume":"42","author":"\u00d6G Doluo\u011flu","year":"2016","unstructured":"Doluo\u011flu \u00d6G, Karag\u00f6z MA, K\u0131l\u0131n\u00e7 MF, Karakan T, Y\u00fccet\u00fcrk CN, Sar\u0131c\u0131 H, \u00d6zg\u00fcr BC, Ero\u011flu M (2016) Overview of different scoring systems in Fournier\u2019s gangrene and assessment of prognostic factors. Turk Urol Derg 42(3):190\u2013196. https:\/\/doi.org\/10.5152\/tud.2016.14194","journal-title":"Turk Urol Derg"},{"issue":"9","key":"4552_CR8","doi-asserted-by":"publisher","first-page":"1359","DOI":"10.1111\/j.1464-410X.2012.11082.x","volume":"110","author":"F Roghmann","year":"2012","unstructured":"Roghmann F, von Bodman C, L\u00f6ppenberg B, Hinkel A, Palisaar J, Noldus J (2012) Is there a need for the Fournier\u2019s gangrene severity index? Comparison of scoring systems for outcome prediction in patients with Fournier\u2019s gangrene. BJU Int 110(9):1359\u20131365. https:\/\/doi.org\/10.1111\/j.1464-410X.2012.11082.x","journal-title":"BJU Int"},{"issue":"1","key":"4552_CR9","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1177\/03915603211046483","volume":"89","author":"S Wirjopranoto","year":"2022","unstructured":"Wirjopranoto S, Azmi YA (2022) Outcome management of Fournier\u2019s gangrene cases at tertiary hospital: 7 years experience. Urologia 89(1):104\u2013107","journal-title":"Urologia"},{"issue":"1","key":"4552_CR10","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/S0022-5347(01)67236-7","volume":"154","author":"E Laor","year":"1995","unstructured":"Laor E, Palmer LS, Tolia BM, Reid RE, Winter HI (1995) Outcome prediction in patients with Fournier\u2019s gangrene. J Urol 154(1):89\u201392","journal-title":"J Urol"},{"key":"4552_CR11","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1007\/s10151-010-0592-1","volume":"14","author":"T Yilmazlar","year":"2010","unstructured":"Yilmazlar T, Ozturk E, Ozguc H, Ercan I, Vuruskan H, Oktay B (2010) Fournier\u2019s gangrene: an analysis of 80 patients and a novel scoring system. Tech Coloproctol\u00a014:217\u2013223.\u00a0https:\/\/doi.org\/10.1007\/s10151-010-0592-1","journal-title":"Tech Coloproctol"},{"issue":"7","key":"4552_CR12","doi-asserted-by":"publisher","first-page":"696","DOI":"10.1111\/iju.12426","volume":"21","author":"T-Y Lin","year":"2014","unstructured":"Lin T-Y, Ou C-H, Tzai T-S, Tong Y-C, Chang C-C, Cheng H-L, Yang W-H, Lin Y-M (2014) Validation and simplification of Fournier\u2019s gangrene severity index. Int J Urol Off J Jpn Urol Assoc 21(7):696\u2013701. https:\/\/doi.org\/10.1111\/iju.12426","journal-title":"Int J Urol Off J Jpn Urol Assoc"},{"issue":"4","key":"4552_CR13","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1007\/s00068-015-0572-2","volume":"42","author":"A Erdo\u011fan","year":"2016","unstructured":"Erdo\u011fan A, Aydo\u011fan I, \u015eenol K, \u00dc\u00e7kan EM, Ers\u00f6z \u015e, Tez M (2016) Simple scoring system for prediction of mortality in Fournier\u2019s gangrene. Eur J Trauma Emerg Surg Off Publ Eur Trauma Soc 42(4):513\u2013518. https:\/\/doi.org\/10.1007\/s00068-015-0572-2","journal-title":"Eur J Trauma Emerg Surg Off Publ Eur Trauma Soc"},{"issue":"2","key":"4552_CR14","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1007\/s11255-014-0897-5","volume":"47","author":"O Bozkurt","year":"2015","unstructured":"Bozkurt O, Sen V, Demir O, Esen A (2015) Evaluation of the utility of different scoring systems (FGSI, LRINEC and NLR) in the management of Fournier\u2019s gangrene. Int Urol Nephrol 47(2):243\u2013248. https:\/\/doi.org\/10.1007\/s11255-014-0897-5","journal-title":"Int Urol Nephrol"},{"issue":"3","key":"4552_CR24","doi-asserted-by":"publisher","first-page":"696","DOI":"10.1007\/s12262-020-02421-6","volume":"83","author":"MA Usta","year":"2021","unstructured":"Usta MA, Ulusahin M, Tayar S, Cekic AB, Kazaz IO, Guner A, Turkyilmaz S (2021) Scoring systems for the prediction of mortality in patient with Fournier\u2019s gangrene: an analysis of 60 patients. Indian J Surg 83(3):696\u2013702. https:\/\/doi.org\/10.1007\/s12262-020-02421-6","journal-title":"Indian J Surg"},{"issue":"1","key":"4552_CR15","doi-asserted-by":"publisher","first-page":"20802","DOI":"10.1038\/s41598-020-77967-2","volume":"10","author":"A Elias","year":"2020","unstructured":"Elias A, Agbarieh R, Saliba W, Khoury J, Bahouth F, Nashashibi J, Azzam ZS (2020) SOFA score and short-term mortality in acute decompensated heart failure. Sci Rep 10(1):20802. https:\/\/doi.org\/10.1038\/s41598-020-77967-2","journal-title":"Sci Rep"},{"key":"4552_CR16","unstructured":"FDA-NIH Biomarker Working Group (2016) BEST (Biomarkers, EndpointS, and other Tools) resource [Internet]. Food and Drug Administration (US), Diagnostic Biomarker, Silver Spring, MD. Available from https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK402285\/ co-published by National Institutes of Health (US), Bethesda (MD). Accessed 30 May 2023"},{"key":"4552_CR17","doi-asserted-by":"publisher","first-page":"9824","DOI":"10.1038\/s41598-023-36585-4","volume":"13","author":"SG Kandinata","year":"2023","unstructured":"Kandinata SG, Widajanti N, Ichwani J, Firdausi H, Aryana IGPS, Alkaff FF (2023) Diagnostic performance of calf circumference, SARC-F, and SARC-CalF for possible sarcopenia screening in Indonesia. Sci Rep 13:9824. https:\/\/doi.org\/10.1038\/s41598-023-36585-4","journal-title":"Sci Rep"},{"issue":"2","key":"4552_CR18","first-page":"98113","volume":"10","author":"F Putra","year":"2020","unstructured":"Putra F, Kadar DD, Warli SM (2020) Fournier gangrene severity index (FGSI) and simplified Fournier gangrene severity index (SFGSI) as a predictor of mortality in H. Adam Malik General Hospital Medan. Int J Sci Res Publ (IJSRP) 10(2):98113","journal-title":"Int J Sci Res Publ (IJSRP)"},{"key":"4552_CR19","doi-asserted-by":"publisher","first-page":"341","DOI":"10.2147\/RRU.S309145","volume":"13","author":"BS Noegroho","year":"2021","unstructured":"Noegroho BS, Siregar S, Mustafa A, Rivaldi MA (2021) Validation of fgsi scores in predicting Fournier gangrene in tertiary hospital. Res Rep Urol 13:341\u2013346. https:\/\/doi.org\/10.2147\/RRU.S309145","journal-title":"Res Rep Urol"},{"issue":"3","key":"4552_CR20","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1159\/000495144","volume":"102","author":"A Arora","year":"2019","unstructured":"Arora A, Rege S, Surpam S, Gothwal K, Narwade A (2019) Predicting mortality in Fournier gangrene and validating the Fournier gangrene severity index: our experience with 50 patients in a tertiary care center in India. Urol Int 102(3):311\u2013318. https:\/\/doi.org\/10.1159\/000495144","journal-title":"Urol Int"},{"issue":"2","key":"4552_CR21","first-page":"122","volume":"100","author":"A Itaimi","year":"2022","unstructured":"Itaimi A, Triki W, Abbassi I, Ayed K, Baraket O, Bouchoucha S (2022) Fournier\u2019s Gangrene: validation of the severity index. Tunis Med 100(2):122\u2013126","journal-title":"Tunis Med"},{"issue":"12","key":"4552_CR22","doi-asserted-by":"publisher","first-page":"690","DOI":"10.53350\/pjmhs20221612690","volume":"16","author":"M Jafar","year":"2022","unstructured":"Jafar M, Shah M, Iqbal J, Islam ZU, Ullah M (2022) Fournier\u2019s gangrene 5-year experience and validity of Fournier gangrene severity index. Pak J Med Health Sci 16(12):690\u2013692. https:\/\/doi.org\/10.53350\/pjmhs20221612690","journal-title":"Pak J Med Health Sci"},{"issue":"2","key":"4552_CR23","doi-asserted-by":"publisher","first-page":"118","DOI":"10.4274\/jus.galenos.2018.2327","volume":"6","author":"S Yal\u00e7\u0131nkaya","year":"2019","unstructured":"Yal\u00e7\u0131nkaya S, Y\u0131ld\u0131z A, Y\u00fcksel M, \u0130slamo\u011flu E, Ate\u015f N, Tokg\u00f6z H, Sava\u015f M (2019) Can we predict mortality in patients with Fournier\u2019s gangrene using questionnaires? A pilot study with eighty-seven patients. J Urol Surg 6(2):118\u2013124. https:\/\/doi.org\/10.4274\/jus.galenos.2018.2327","journal-title":"J Urol Surg"},{"issue":"3","key":"4552_CR25","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1001\/jama.2016.20328","volume":"317","author":"EP Raith","year":"2017","unstructured":"Raith EP, Udy AA, Bailey M, McGloughlin S, MacIsaac C, Bellomo R, Pilcher DV (2017) Prognostic accuracy of the SOFA score, SIRS criteria, and qSOFA score for in-hospital mortality among adults with suspected infection admitted to the intensive care unit. JAMA 317(3):290\u2013300. https:\/\/doi.org\/10.1001\/jama.2016.20328","journal-title":"JAMA"},{"issue":"32","key":"4552_CR26","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000026900","volume":"100","author":"Z Yang","year":"2021","unstructured":"Yang Z, Hu Q, Huang F, Xiong S, Sun Y (2021) The prognostic value of the SOFA score in patients with COVID-19: a retrospective, observational study. Medicine 100(32):e26900. https:\/\/doi.org\/10.1097\/MD.0000000000026900","journal-title":"Medicine"},{"issue":"1","key":"4552_CR27","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1177\/000313481808400127","volume":"84","author":"M Lauerman","year":"2018","unstructured":"Lauerman M, Kolesnik O, Park H, Buchanan LS, Chiu W, Tesoriero RB, Stein D, Scalea T, Henry S (2018) Definitive wound closure techniques in Fournier\u2019s gangrene. Am Surg 84(1):86\u201392","journal-title":"Am Surg"},{"issue":"5","key":"4552_CR28","doi-asserted-by":"publisher","first-page":"333","DOI":"10.5505\/tjtes.2014.06870","volume":"20","author":"T Yilmazlar","year":"2014","unstructured":"Yilmazlar T, I\u015fik \u00d6, \u00d6zt\u00fcrk E, \u00d6zer A, G\u00fclc\u00fc B, Ercan I (2014) Fournier\u2019s gangrene: review of 120 patients and predictors of mortality. Ulus Travma Acil Cerrahi Derg 20(5):333\u2013337. https:\/\/doi.org\/10.5505\/tjtes.2014.06870","journal-title":"Ulus Travma Acil Cerrahi Derg"}],"container-title":["World Journal of Urology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00345-023-04552-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00345-023-04552-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00345-023-04552-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T13:07:04Z","timestamp":1697548024000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00345-023-04552-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,14]]},"references-count":28,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["4552"],"URL":"https:\/\/doi.org\/10.1007\/s00345-023-04552-3","relation":{},"ISSN":["1433-8726"],"issn-type":[{"value":"1433-8726","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,14]]},"assertion":[{"value":"4 June 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 July 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 August 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"MJP received grants and honoraria from various pharmaceutical companies, all fully unrelated to this research. Other authors have no conflict of interest to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study involved human participants. This study has been approved by the ethical review board of Dr. Soetomo General Academic Hospital (0911\/LOE\/301.4.2\/V\/2022).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Research involving human participants"}},{"value":"The requirement of written informed consent was waived because this was a retrospective study and only used data from medical records.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}