{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T13:47:43Z","timestamp":1785764863401,"version":"3.56.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Fournier\u2019s gangrene is a life-threatening necrotizing fasciitis with mortality rates of 20%\u201350%. Early identification of high-risk patients is essential, yet practical prognostic tools derived from routine laboratory tests remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To compare seven prognostic indices and develop a novel procalcitonin-based index (PCT-ALLY) for mortality prediction in patients with Fournier\u2019s gangrene.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this single-center retrospective cohort, 220 surgically treated patients (January 2007\u2013September 2025) were evaluated. Preoperative laboratory data were used to calculate neutrophil\u2013to\u2013lymphocyte ratio (NLR), platelet\u2013to\u2013lymphocyte ratio, hemoglobin\u2013albumin\u2013lymphocyte\u2013platelet (HALP), prognostic nutritional index, systemic inflammation response index (SIRI), C\u2013reactive protein\u2013albumin\u2013lymphocyte (CALLY), and the newly developed PCT-ALLY. The primary endpoint was 30-day or in-hospital mortality. Discrimination was assessed using receiver operating characteristic analysis with DeLong testing and multivariable logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Mortality occurred in 66 patients (30%). CALLY showed the highest area under the curve (0.935; 95% confidence interval [CI] 0.890\u20130.965), followed by PCT-ALLY (0.874; 95% CI 0.821\u20130.916). PCT-ALLY had the highest specificity (87.0%) and outperformed NLR (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.032) and SIRI (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.045). In multivariable analysis, CALLY (odds ratio [OR] 7.210;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), HALP (OR 3.816;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), and PCT-ALLY (OR 3.649;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) were independent predictors of mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Immuno-nutritional indices, particularly CALLY and PCT-ALLY, provide strong, easily calculable, and cost-effective mortality prediction in Fournier\u2019s gangrene and may support early risk stratification. Prospective multicenter validation is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/njcp.njcp_127_26","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T04:05:15Z","timestamp":1785384315000},"page":"820-827","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic Indices for Mortality Prediction in Fournier\u2019s Gangrene: A Comparative Study Introducing PCT-ALLY"],"prefix":"10.4103","volume":"29","author":[{"given":"M","family":"Sesli","sequence":"first","affiliation":[{"name":"Urology Department, Malatya Education and Research Hospital, Malatya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Ba\u015farano\u011flu","sequence":"additional","affiliation":[{"name":"Department of Urology Mersin University Hospital, Mersin, 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