{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T13:48:24Z","timestamp":1784296104904,"version":"3.55.0"},"reference-count":15,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,7]]},"abstract":"\n Background<\/jats:title>\n Fournier gangrene (FG) remains a life-threatening necrotizing infection with persistently high mortality despite advances in surgical and supportive care. Reliable early prognostic markers are therefore essential. The C-reactive protein\u2013albumin\u2013lymphocyte (CALLY) index, which integrates inflammatory, nutritional, and immune status, has shown prognostic value in several critical illness settings, but its utility in FG has not been adequately evaluated.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This multicenter retrospective cohort study included 136 adults who underwent surgical treatment for FG between 2015 and 2025. Demographic variables, comorbidities, laboratory parameters, qSOFA scores, and 30-day outcomes were analyzed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The 30-day mortality rate was 17% (23\/136). Non-survivors had significantly lower albumin and lymphocyte levels, higher CRP levels, and markedly reduced CALLY indices compared with survivors (0.005 vs 0.039,\n P<\/jats:italic>\n < 0.001). The CALLY index demonstrated strong discriminative performance for 30-day mortality (AUC = 0.886; 95% CI: 0.780-0.991). A cutoff \u22640.012 provided 82.6% sensitivity and 95.6% specificity. In multivariate analysis, CALLY \u22640.012 (OR 42.61;\n P<\/jats:italic>\n < 0.001) and qSOFA score 2-3 (OR 12.97;\n P<\/jats:italic>\n = 0.019) emerged as strong independent predictors of mortality, whereas age, sex, uncontrolled diabetes, CAD, immunosuppression, and malignancy were not independently associated with death.\n <\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n The C-reactive protein\u2013albumin\u2013lymphocyte (CALLY) index was independently associated with 30-day mortality in patients with Fournier gangrene and may serve as a simple adjunctive biomarker for early risk stratification when interpreted alongside established clinical scoring systems such as qSOFA. Incorporating the CALLY index into early risk-stratification algorithms may facilitate timely clinical decision-making and more targeted management strategies for high-risk FG patients.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/00031348261421668","type":"journal-article","created":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T03:56:22Z","timestamp":1769831782000},"page":"1902-1909","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["CALLY Index as a Prognostic Marker for 30-Day Mortality in Fournier Gangrene: A Multicenter Retrospective Cohort Study"],"prefix":"10.1177","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4858-7480","authenticated-orcid":false,"given":"F\u0131rat","family":"Canlikarakaya","sequence":"first","affiliation":[{"name":"Amasya University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3471-8726","authenticated-orcid":false,"given":"Cengiz","family":"Ceylan","sequence":"additional","affiliation":[{"name":"Eski\u015fehir City Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7413-1837","authenticated-orcid":false,"given":"\u0130brahim","family":"Do\u011fan","sequence":"additional","affiliation":[{"name":"Van Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3176-4914","authenticated-orcid":false,"given":"Serhat","family":"Ocakli","sequence":"additional","affiliation":[{"name":"Ankara Medipol University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4669-0962","authenticated-orcid":false,"given":"Sabiha Nur","family":"\u00d6zmen","sequence":"additional","affiliation":[{"name":"Amasya Sabuncuo\u011flu \u015eerefeddin Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7491-3134","authenticated-orcid":false,"given":"H\u00fcseyin","family":"Turap","sequence":"additional","affiliation":[{"name":"Amasya Sabuncuo\u011flu \u015eerefeddin Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,30]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.14744\/tjtes.2023.08903"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics14232732"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2024.1504946"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.3390\/medicina61030538"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajur.2021.11.003"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.24875\/CIRU.22000529"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-023-04552-3"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/idr17030055"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1080\/08941939.2024.2432958"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1395134"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-025-04596-w"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.5505\/tjtes.2014.06870"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2005.6.427"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgac278"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijregi.2025.100567"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261421668","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348261421668","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261421668","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T09:48:16Z","timestamp":1779788896000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348261421668"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,30]]},"references-count":15,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1177\/00031348261421668"],"URL":"https:\/\/doi.org\/10.1177\/00031348261421668","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,30]]}}}