Surviving Fournier’s Gangrene: Predicting Length of Stay With the CUPI Score | Dr. Daniel Gould

Dr. Daniel Gould co-authored this study published in the Journal of Plastic, Reconstructive & Aesthetic Surgery, examining factors associated with hospital length of stay in patients with Fournier’s gangrene and evaluating a novel scoring system designed to predict the duration of hospitalization.

Fournier’s gangrene is a rapidly progressing necrotizing soft tissue infection that can require aggressive surgical treatment, critical care, and subsequent reconstruction. As advances in treatment have improved survival, greater attention has shifted toward reducing morbidity, anticipating resource needs, and understanding the factors that contribute to prolonged hospitalization.

The researchers retrospectively reviewed 54 patients treated for Fournier’s gangrene at LAC+USC Medical Center between 2010 and 2016. They examined predictors of hospital length of stay, morbidity, mortality, resource utilization, and the need for reconstructive surgery.

The team used significant clinical predictors to develop the Combined Urology and Plastics Index, or CUPI. The new score was then compared with existing measures used in patients with severe infections. In this study, CUPI demonstrated a significant relationship with longer hospital stays, while the other evaluated scoring systems did not show a significant correlation with length of stay.

The study also demonstrated the substantial treatment burden associated with the condition. Patients were hospitalized for an average of 37.5 days, and 61 percent required reconstructive surgery. The authors highlighted supportive care, nutrition, operative intervention, and involvement of reconstructive surgeons as important components of multidisciplinary treatment.

This research provides a more detailed framework for evaluating recovery after Fournier’s gangrene, shifting attention beyond mortality toward the duration and complexity of treatment. The CUPI score may help clinicians identify patients likely to require more extensive hospital management and reconstructive care.