Preoperative computed tomography in Fournier’s gangrene does not delay time to surgery

Purpose Fournier’s gangrene (FG), a rapidly progressive necrotizing soft tissue infection of the external genitalia and perineum, necessitates urgent surgical debridement. The time to surgery effect of preoperative computed tomography (CT) in managing this condition is yet to be fully explored. The...

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Veröffentlicht in:Emergency radiology 2023-12, Vol.30 (6), p.711-717
Hauptverfasser: Ganapathy, Aravinda, Ballard, David H., Chen, David Z., Schneider, McGinness, Lanier, M. Hunter, Mazaheri, Parisa, Ilahi, Obeid, Kirby, John P., Raptis, Constantine A., Mellnick, Vincent M.
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container_end_page 717
container_issue 6
container_start_page 711
container_title Emergency radiology
container_volume 30
creator Ganapathy, Aravinda
Ballard, David H.
Chen, David Z.
Schneider, McGinness
Lanier, M. Hunter
Mazaheri, Parisa
Ilahi, Obeid
Kirby, John P.
Raptis, Constantine A.
Mellnick, Vincent M.
description Purpose Fournier’s gangrene (FG), a rapidly progressive necrotizing soft tissue infection of the external genitalia and perineum, necessitates urgent surgical debridement. The time to surgery effect of preoperative computed tomography (CT) in managing this condition is yet to be fully explored. The purpose of this study was to assess whether obtaining a preoperative CT in patients with FG impacts the time to surgical intervention. Methods This was a single-center retrospective study of patients who underwent CT prior to surgical debridement of FG during a 9-year period vs patients who did not undergo CT. In 76 patients (male = 39, mean age = 51.8), 38 patients with FG received a preoperative CT, and 38 patients with FG did not receive CT prior to surgical debridement. Time to operating room and outcome metrics were compared between CT and non-CT groups. Results The time from hospital presentation to surgical intervention was not significantly different between patients who underwent CT and those who did not (6.65 ± 3.71 vs 5.73 ± 4.33 h, p = 0.37). There were also no significant differences in cost ($130,000 ± $102,000 vs $142,000 ± $152,000, p = 0.37), mortality (8 vs 7, p = 1), duration of hospital stay (15.5 ± 15 vs 15.7 ± 11.6 days, p = 0.95), average intensive care unit stay (5.82 ± 5.38 days vs 6.97 ± 8.58 days, p = 0.48), and APACHE score (12 ± 4.65 vs 13.9 ± 5.6, p =0.12). Conclusion Obtaining a preoperative CT did not delay surgical intervention in patients with FG.
doi_str_mv 10.1007/s10140-023-02177-y
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Hunter ; Mazaheri, Parisa ; Ilahi, Obeid ; Kirby, John P. ; Raptis, Constantine A. ; Mellnick, Vincent M.</creator><creatorcontrib>Ganapathy, Aravinda ; Ballard, David H. ; Chen, David Z. ; Schneider, McGinness ; Lanier, M. Hunter ; Mazaheri, Parisa ; Ilahi, Obeid ; Kirby, John P. ; Raptis, Constantine A. ; Mellnick, Vincent M.</creatorcontrib><description>Purpose Fournier’s gangrene (FG), a rapidly progressive necrotizing soft tissue infection of the external genitalia and perineum, necessitates urgent surgical debridement. The time to surgery effect of preoperative computed tomography (CT) in managing this condition is yet to be fully explored. The purpose of this study was to assess whether obtaining a preoperative CT in patients with FG impacts the time to surgical intervention. Methods This was a single-center retrospective study of patients who underwent CT prior to surgical debridement of FG during a 9-year period vs patients who did not undergo CT. In 76 patients (male = 39, mean age = 51.8), 38 patients with FG received a preoperative CT, and 38 patients with FG did not receive CT prior to surgical debridement. Time to operating room and outcome metrics were compared between CT and non-CT groups. Results The time from hospital presentation to surgical intervention was not significantly different between patients who underwent CT and those who did not (6.65 ± 3.71 vs 5.73 ± 4.33 h, p = 0.37). There were also no significant differences in cost ($130,000 ± $102,000 vs $142,000 ± $152,000, p = 0.37), mortality (8 vs 7, p = 1), duration of hospital stay (15.5 ± 15 vs 15.7 ± 11.6 days, p = 0.95), average intensive care unit stay (5.82 ± 5.38 days vs 6.97 ± 8.58 days, p = 0.48), and APACHE score (12 ± 4.65 vs 13.9 ± 5.6, p =0.12). Conclusion Obtaining a preoperative CT did not delay surgical intervention in patients with FG.</description><identifier>ISSN: 1438-1435</identifier><identifier>ISSN: 1070-3004</identifier><identifier>EISSN: 1438-1435</identifier><identifier>DOI: 10.1007/s10140-023-02177-y</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Computed tomography ; Debridement ; Delay time ; Emergency Medicine ; Gangrene ; Hospitals ; Imaging ; Medicine ; Medicine &amp; Public Health ; Original Article ; Radiology ; Soft tissues ; Surgery ; Tomography</subject><ispartof>Emergency radiology, 2023-12, Vol.30 (6), p.711-717</ispartof><rights>The Author(s), under exclusive licence to American Society of Emergency Radiology (ASER) 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c352t-92de6f0ef5a07a2d79e3a29e0b93957648c9915cc6e6a80aab95041d2b6e79ee3</citedby><cites>FETCH-LOGICAL-c352t-92de6f0ef5a07a2d79e3a29e0b93957648c9915cc6e6a80aab95041d2b6e79ee3</cites><orcidid>0000-0001-7470-3364</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10140-023-02177-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10140-023-02177-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids></links><search><creatorcontrib>Ganapathy, Aravinda</creatorcontrib><creatorcontrib>Ballard, David H.</creatorcontrib><creatorcontrib>Chen, David Z.</creatorcontrib><creatorcontrib>Schneider, McGinness</creatorcontrib><creatorcontrib>Lanier, M. Hunter</creatorcontrib><creatorcontrib>Mazaheri, Parisa</creatorcontrib><creatorcontrib>Ilahi, Obeid</creatorcontrib><creatorcontrib>Kirby, John P.</creatorcontrib><creatorcontrib>Raptis, Constantine A.</creatorcontrib><creatorcontrib>Mellnick, Vincent M.</creatorcontrib><title>Preoperative computed tomography in Fournier’s gangrene does not delay time to surgery</title><title>Emergency radiology</title><addtitle>Emerg Radiol</addtitle><description>Purpose Fournier’s gangrene (FG), a rapidly progressive necrotizing soft tissue infection of the external genitalia and perineum, necessitates urgent surgical debridement. The time to surgery effect of preoperative computed tomography (CT) in managing this condition is yet to be fully explored. The purpose of this study was to assess whether obtaining a preoperative CT in patients with FG impacts the time to surgical intervention. Methods This was a single-center retrospective study of patients who underwent CT prior to surgical debridement of FG during a 9-year period vs patients who did not undergo CT. In 76 patients (male = 39, mean age = 51.8), 38 patients with FG received a preoperative CT, and 38 patients with FG did not receive CT prior to surgical debridement. Time to operating room and outcome metrics were compared between CT and non-CT groups. Results The time from hospital presentation to surgical intervention was not significantly different between patients who underwent CT and those who did not (6.65 ± 3.71 vs 5.73 ± 4.33 h, p = 0.37). There were also no significant differences in cost ($130,000 ± $102,000 vs $142,000 ± $152,000, p = 0.37), mortality (8 vs 7, p = 1), duration of hospital stay (15.5 ± 15 vs 15.7 ± 11.6 days, p = 0.95), average intensive care unit stay (5.82 ± 5.38 days vs 6.97 ± 8.58 days, p = 0.48), and APACHE score (12 ± 4.65 vs 13.9 ± 5.6, p =0.12). 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Hunter</au><au>Mazaheri, Parisa</au><au>Ilahi, Obeid</au><au>Kirby, John P.</au><au>Raptis, Constantine A.</au><au>Mellnick, Vincent M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preoperative computed tomography in Fournier’s gangrene does not delay time to surgery</atitle><jtitle>Emergency radiology</jtitle><stitle>Emerg Radiol</stitle><date>2023-12-01</date><risdate>2023</risdate><volume>30</volume><issue>6</issue><spage>711</spage><epage>717</epage><pages>711-717</pages><issn>1438-1435</issn><issn>1070-3004</issn><eissn>1438-1435</eissn><abstract>Purpose Fournier’s gangrene (FG), a rapidly progressive necrotizing soft tissue infection of the external genitalia and perineum, necessitates urgent surgical debridement. The time to surgery effect of preoperative computed tomography (CT) in managing this condition is yet to be fully explored. The purpose of this study was to assess whether obtaining a preoperative CT in patients with FG impacts the time to surgical intervention. Methods This was a single-center retrospective study of patients who underwent CT prior to surgical debridement of FG during a 9-year period vs patients who did not undergo CT. In 76 patients (male = 39, mean age = 51.8), 38 patients with FG received a preoperative CT, and 38 patients with FG did not receive CT prior to surgical debridement. Time to operating room and outcome metrics were compared between CT and non-CT groups. Results The time from hospital presentation to surgical intervention was not significantly different between patients who underwent CT and those who did not (6.65 ± 3.71 vs 5.73 ± 4.33 h, p = 0.37). There were also no significant differences in cost ($130,000 ± $102,000 vs $142,000 ± $152,000, p = 0.37), mortality (8 vs 7, p = 1), duration of hospital stay (15.5 ± 15 vs 15.7 ± 11.6 days, p = 0.95), average intensive care unit stay (5.82 ± 5.38 days vs 6.97 ± 8.58 days, p = 0.48), and APACHE score (12 ± 4.65 vs 13.9 ± 5.6, p =0.12). Conclusion Obtaining a preoperative CT did not delay surgical intervention in patients with FG.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><doi>10.1007/s10140-023-02177-y</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-7470-3364</orcidid></addata></record>
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subjects Computed tomography
Debridement
Delay time
Emergency Medicine
Gangrene
Hospitals
Imaging
Medicine
Medicine & Public Health
Original Article
Radiology
Soft tissues
Surgery
Tomography
title Preoperative computed tomography in Fournier’s gangrene does not delay time to surgery
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