PURPOSE: To evaluate the association of traditional and novel nutritional measurements with survival in Fournier's gangrene (FG) patients. METHODS: We reviewed records of FG patients from our tertiary center (Jan 2013-Jan 2022). Radiomic sarcopenia parameters (Psoas Muscle Area [PMA], Roundness, Solidity, and calculated PMA-Index) were measured from admission CT scans at the L3 level using ImageJ software. We assessed sarcopenia's impact on survival through three analyses: Model 1 used a PMI below the sex-adjusted median
Models 2 and 3 used published cutoffs. Kaplan-Meier curves were used to compare survival between sarcopenic and non-sarcopenic patients. Multivariable Cox and logistic regression analyses adjusted for age and the Charlson Comorbidity Index (CCI) to assess mortality risk. RESULTS: Of 130 men and 31 women (82% white), 60 patients (37.3%) had died after a median follow-up of 2.2 years (IQR 0.9-4.4). Survival rates were 94% at 30 days, 92% at 90 days, 80% at 1 year, 77% at 2 years, and 56% at 5 years. Non-survivors were older (median age 63 vs 55.1 years, CONCLUSIONS: Despite a mild trend, none of the sarcopenia models were able to predict long-term mortality in FG patients in our cohort. This well-known, cost-effective nutritional predictor still requires further research to optimize its utilization in the FG patient population.