Laboratory Risk Indicator for Necrotizing Fasciitis Score and the Outcomes

Abstract

Background: Laboratory risk indicator for necrotizing fasciitis (LRINEC score) is a simple laboratory tool used to distinguish between necrotizing soft-tissue infections (NSTI) and other soft-tissue infections. A LRINEC score of ‡6 is considered as denoting a high risk of necrotizing fasciitis. A certain LRINEC score might also be associated with mortality and other outcomes of patients with NSTI. Methods: A review of the medical charts of patients was carried out. The study sites were one tertiary academic centre and one community, university-affiliated hospital. All adult patients with necrotizing soft-tissue infections from 2002 to 2005 were selected then LRINEC scores were calculated for each patient. We enrolled patients where there was sufficient information to determine that the LRINEC score was either <6 or ‡6. Results: A total of two hundred and nine patients were enrolled and analysed. The overall mortality rate was 33 of 209 (15.8%) and amputation rate was 55 of 209 (26.3%). The amputation rates were defined as numbers of patients who received amputation divided by numbers of total patients. Enrolled patients were divided into two groups. Group I was those whose LRINEC score was <6 and group II was those whose LRINEC score was ‡6. Significant differences in mortality rate (P = 0.04) and amputation rate (P = 0.002) were noted between two groups. Conclusion: The LRINEC score is associated with the outcomes of patients with NSTI. Patients with a LRINEC score of ‡6 have a higher rate of both mortality and amputation.

Laboratory risk indicator for necrotising fasciitis (LRINEC) score for the assessment of early necrotising fasciitis: a systematic review of the literature

“…After the application of inclusion and exclusion criteria at the first and second level of screening, 16 articles were included in the final analysis (Kappa 0.72; Fig 1). 9,[16][17][18][19][21][22][23][24][25][26][27][28][29][30][31] The mean MINORS score for comparative studies was 8.6 and 7.0 for non-comparative studies.…”

Pressure sores significantly increase the risk of developing a Fournier's gangrene in patients with spinal cord injury

“…Su et al 8 reported on the LRINEC score in patients with necrotizing fasciitis. A significant correlation was found between LRINEC X6 and mortality as well as complication rate.…”

“…Also, the laboratory risk indicator for necrotizing fasciitis (LRINEC) score were calculated on admission in all patients. 7,8 The LRINEC score, which is composed of the following six laboratory tests: glucose level, C-reactive protein level, white blood cell count, sodium level, creatinine level and hemoglobin is a useful adjunct in the initial diagnosis of necrotizing soft tissue infections. 7-9 As Fournier's gangrene is considered a necrotizing infection of the urogenital tract, we used the LRINEC score in our study.…”

Does spinal cord injury influence the mortality rate in patients with necrotizing fasciitis?

“…1,2 In contrast, our results showed a significantly lower mortality rate of NF in patients with SCI compared with patients without a SCI. Su et al 7 reported that patients with a LRINEC score of X6 have higher rates of mortality and amputation. This was also confirmed in our study.…”

“…The maximum score is 13, a score X6 is suspicious for NF and a score X8 strongly predictive for NF. [7][8][9] Aggressive physiological fluid resuscitation, correction of electrolyte imbalances, extensive operative debridement, antiseptic wound-dressing changes using sterile gauzes and wide-spectrum antibiotic therapy were the therapeutic strategy used in all patients. Radical surgical debridement was required in almost every case before soft tissue closure.…”