Prognostic value of semiquantitative serum Procalcitonine vs APACHE or SOFA scores in patients with descending necrotizing mediastinitis

Bolaños-Morales, Francina Valezka; Peña, E.; Guzmán-de-Alba, Enrique; Santillán-Doherty, Patricio; Sotres-Vega, Avelina; Santibáñez-Salgado, J. Alfredo; Villalba-Caloca, Jaime

doi:10.1183/13993003.congress-2015.pa1517

8.1 Thoracic Surgery 2015

DOI: 10.1183/13993003.congress-2015.pa1517

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Prognostic value of semiquantitative serum Procalcitonine vs APACHE or SOFA scores in patients with descending necrotizing mediastinitis

Francina Valezka Bolaños-Morales¹,

E. Peña²,

Enrique Guzmán-de-Alba³

et al.

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2017

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The laboratory risk indicator for necrotizing fasciitis (LRINEC) scoring: the diagnostic and potential prognostic role

El‐Menyar

Asim

Mudali

et al. 2017

Scand J Trauma Resusc Emerg Med

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BackgroundNecrotizing fasciitis (NF) is a devastating soft tissue infection associated with potentially poor outcomes. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score has been introduced as a diagnostic tool for NF. We aimed to evaluate the prognostic value of LRINEC scoring in NF patients.MethodsA retrospective analysis was conducted for patients who were admitted with NF between 2000 and 2013. Based on LRINEC points, patients were classified into (Group 1: LRINEC < 6 and Group 2: LRINEC ≥ 6). The 2 groups were analyzed and compared. Primary outcomes were hospital length of stay, septic shock and hospital death.ResultsA total of 294 NF cases were identified with a mean age 50.9 ± 15 years. When compared to Group1, patients in Group 2 were 5 years older (p = 0.009), more likely to have diabetes mellitus (61 vs 41%, p < 0.001), Pseudomonas aeruginosa infection (p = 0.004), greater Sequential Organ Failure Assessment (SOFA) score (11.5 ± 3 vs 8 ± 2, p = 0.001), and prolonged intensive care (median 7 vs 5 days) and hospital length of stay (22 vs 11 days, p = 0.001). Septic shock (37 vs. 15%, p = 0.001) and mortality (28.8 vs. 15.0%, p = 0.005) were also significantly higher in Group 2 patients. Using Receiver operating curve, cutoff LRINEC point for mortality was 8.5 with area under the curve of 0.64. Pearson correlation analysis showed a significant correlation between LRINEC and SOFA scorings (r = 0.51, p < 0.002).DiscussionEarly diagnosis, simplified risk stratification and on-time management are vital to achieve better outcomes in patients with NF.ConclusionsBeside its diagnostic role, LRINEC scoring could predict worse hospital outcomes in patients with NF and simply identify the high-risk patients. However, further prospective studies are needed to support this finding.

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The laboratory risk indicator for necrotizing fasciitis (LRINEC) scoring: the diagnostic and potential prognostic role

El‐Menyar

Asim

Mudali

et al. 2017

Scand J Trauma Resusc Emerg Med

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Prognostic value of semiquantitative serum Procalcitonine vs APACHE or SOFA scores in patients with descending necrotizing mediastinitis

Cited by 1 publication

References 0 publications

The laboratory risk indicator for necrotizing fasciitis (LRINEC) scoring: the diagnostic and potential prognostic role

The laboratory risk indicator for necrotizing fasciitis (LRINEC) scoring: the diagnostic and potential prognostic role

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