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 |
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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 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2880103499</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2880103499</sourcerecordid><originalsourceid>FETCH-LOGICAL-c352t-92de6f0ef5a07a2d79e3a29e0b93957648c9915cc6e6a80aab95041d2b6e79ee3</originalsourceid><addsrcrecordid>eNp9kM1KxDAUhYMoOI6-gKuAGzfVm6RNm6UM_sGALhTchUx7Wzu0TU1aoTtfw9fzScw4guLCxf1ZfOdyzyHkmMEZA0jPPQMWQwRchGJpGk07ZMZikUWhJbu_9n1y4P0aAKSS2Yw83Tu0PToz1K9Ic9v244AFHWxrK2f654nWHb2yo-tqdB9v755WpqscdkgLi552dqAFNmaiQ91i0FE_ugrddEj2StN4PPqec_J4dfmwuImWd9e3i4tllIuED5HiBcoSsEwMpIYXqUJhuEJYKaGSVMZZrhRL8lyiNBkYs1IJxKzgK4mBRTEnp9u7vbMvI_pBt7XPsWlMh3b0mmcZMBCxUgE9-YOuN8bCd4FSacKV5DJQfEvlznrvsNS9q1vjJs1Ab8LW27B1CFt_ha2nIBJbkQ9wF_z_nP5H9Qlj-oQ5</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2897529626</pqid></control><display><type>article</type><title>Preoperative computed tomography in Fournier’s gangrene does not delay time to surgery</title><source>SpringerLink Journals - AutoHoldings</source><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.</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 & 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).
Conclusion
Obtaining a preoperative CT did not delay surgical intervention in patients with FG.</description><subject>Computed tomography</subject><subject>Debridement</subject><subject>Delay time</subject><subject>Emergency Medicine</subject><subject>Gangrene</subject><subject>Hospitals</subject><subject>Imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Radiology</subject><subject>Soft tissues</subject><subject>Surgery</subject><subject>Tomography</subject><issn>1438-1435</issn><issn>1070-3004</issn><issn>1438-1435</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp9kM1KxDAUhYMoOI6-gKuAGzfVm6RNm6UM_sGALhTchUx7Wzu0TU1aoTtfw9fzScw4guLCxf1ZfOdyzyHkmMEZA0jPPQMWQwRchGJpGk07ZMZikUWhJbu_9n1y4P0aAKSS2Yw83Tu0PToz1K9Ic9v244AFHWxrK2f654nWHb2yo-tqdB9v755WpqscdkgLi552dqAFNmaiQ91i0FE_ugrddEj2StN4PPqec_J4dfmwuImWd9e3i4tllIuED5HiBcoSsEwMpIYXqUJhuEJYKaGSVMZZrhRL8lyiNBkYs1IJxKzgK4mBRTEnp9u7vbMvI_pBt7XPsWlMh3b0mmcZMBCxUgE9-YOuN8bCd4FSacKV5DJQfEvlznrvsNS9q1vjJs1Ab8LW27B1CFt_ha2nIBJbkQ9wF_z_nP5H9Qlj-oQ5</recordid><startdate>20231201</startdate><enddate>20231201</enddate><creator>Ganapathy, Aravinda</creator><creator>Ballard, David H.</creator><creator>Chen, David Z.</creator><creator>Schneider, McGinness</creator><creator>Lanier, M. Hunter</creator><creator>Mazaheri, Parisa</creator><creator>Ilahi, Obeid</creator><creator>Kirby, John P.</creator><creator>Raptis, Constantine A.</creator><creator>Mellnick, Vincent M.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FG</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7470-3364</orcidid></search><sort><creationdate>20231201</creationdate><title>Preoperative computed tomography in Fournier’s gangrene does not delay time to surgery</title><author>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.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c352t-92de6f0ef5a07a2d79e3a29e0b93957648c9915cc6e6a80aab95041d2b6e79ee3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Computed tomography</topic><topic>Debridement</topic><topic>Delay time</topic><topic>Emergency Medicine</topic><topic>Gangrene</topic><topic>Hospitals</topic><topic>Imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Radiology</topic><topic>Soft tissues</topic><topic>Surgery</topic><topic>Tomography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><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><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Emergency radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ganapathy, Aravinda</au><au>Ballard, David H.</au><au>Chen, David Z.</au><au>Schneider, McGinness</au><au>Lanier, M. 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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source | SpringerLink Journals - AutoHoldings |
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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