The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: A tool for distinguishing necrotizing fasciitis from other soft tissue infections*

Wong, Chin‐Ho; Khin, Lay Wai; Heng, Kien-Seng; Tan, Kok‐Yang; Low, C O

doi:10.1097/01.ccm.0000129486.35458.7d

Cited by 1,249 publications

(1,127 citation statements)

References 21 publications

Supporting

Mentioning

999

Contrasting

Unclassified

Order By: Relevance

“…An LRINEC of six or greater confers a higher risk of necrotising fasciitis. 9 The LRINEC scoring system has been controversial, with papers questioning its role as a scoring system for prognostic identification. 10,11 Diagnostic scoring has the potential to prevent marked morbidity and mortality in the accurate diagnosis of necrotising fasciitis.…”

Section: Introductionmentioning

confidence: 99%

“…6 Imaging modalities such as computed tomography, magnetic resonance imaging and frozen section biopsy have been previously used in the discrimination between necrotising fasciitis and other soft tissue infections but these methods have been limited by cost and availability. 2,7,8 The Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) is a clinical tool first described by Wong C et al 9 The tool is based on six common serum parameters at the time of presentation: C-reactive protein (CRP), total white cell count, haemoglobin, serum sodium, creatinine and glucose (Table 1). An LRINEC of six or greater confers a higher risk of necrotising fasciitis.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Bechar

Sepehripour

Hardwicke

et al. 2017

annals

149

106

View full text Add to dashboard Cite

INTRODUCTION Early operative debridement of necrotising fasciitis is a major outcome determinant. Identification and diagnosis of such patients can be clinically difficult. The Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) score first published in 2004 is based on routinely performed parameters and offers a method for identifying early cases. No literature review has yet been performed on the application of such a score. METHODS A systematic review of English-language literature was performed from 2004 to 2014 to identify articles reporting use of LRINEC score and the incidence of necrotising fasciitis. We performed a critical review of PubMed, Medline and Embase in line with the PRISMA statement. A meta-analysis was performed with a random effects model and 95% confidence interval. Suitable correlation coefficient and receiver operating characteristic (ROC) curves were also calculated. RESULTS After application of inclusion criteria, 16 studies with 846 patients were included. The mean LRINEC score in patients with necrotising fasciitis was 6.06. Two papers reported LRINEC score in patients without necrotising fasciitis with a mean 2.45. All six studies with a reported coefficient of variance were < 1; Pearson correlation coefficient was r = 0.637 (P = 0.011). An ROC curve showed an area under the curve of 0.927. CONCLUSIONS The LRINEC score is a useful clinical determinant in the diagnosis and surgical treatment of patients with necrotising fasciitis, with a statistically positive correlation between LRINEC score and a true diagnosis of necrotising fasciitis.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Bechar

Sepehripour

Hardwicke

et al. 2017

annals

149

106

View full text Add to dashboard Cite

show abstract

“…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.…”

Section: Methodsmentioning

confidence: 99%

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

Backhaus

Citak

et al. 2011

Spinal Cord

View full text Add to dashboard Cite

Methods: All patients with a SCI and a Fournier's gangrene treated in our hospital were enrolled in this study. Following parameters were taken form patients medical records: age, type of SCI, cause of Fournier's gangrene, number of surgical debridements, length of hospital and intensive care unit stay, co morbidity factors and mortality rate. In addition, laboratory parameter including the laboratory risk indicator for necrotizing fasciitis (LRINEC) score and microbiological findings were analyzed. Clinical diagnosis was made via histological examination. Results: A total of 16 male patients (15 paraplegic and one tetraplegic) were included in the study. In 81% of all cases, the origin of Fournier's gangrene was a pressure sore. The median LRINEC score on admission was 6.5. In the vast majority of cases, a polybacterial infection was found. No patient died during the hospital stay. The mean number of surgical debridements before soft tissue closure was 1.9 and after a mean time interval of 39.1 days wound closure was performed in all patients. Conclusions: Pressure sores significantly increase the risk of developing Fournier's gangrene in patients with SCI. We reported the results of our patients to increase awareness among physicians and training staff working with patients with a SCI in order to expedite the diagnosis.

show abstract

“…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.…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2011

View full text Add to dashboard Cite

Methods: Twenty-five patients with SCI and thirty patients without SCI treated with NF were included in the study. Mean length of hospital stay, mean age, mean laboratory risk indicator for necrotizing fasciitis (LRINEC) score, mean number of surgical debridements, co-morbidity factors and mortality rate were compared between both groups. Results: There were no differences for the mean LRINEC score (P¼0.07), mean number of surgical debridements (P¼0.18) and co-morbidities (odds ratio¼2.32; 95% confidence interval ¼0.78-6.92) between both groups. Patients with SCI were significantly younger than patients without SCI (P¼0.02). Patients without SCI had a higher mortality risk rate (n¼9) than patients with SCI (n¼2) (relative risk¼1.71; 95% confidence interval ¼1.13-2.6). Conclusions: In conclusion, SCI patients have a lower mortality rate than patients without SCI. Age may influence the mortality rate. Nevertheless, we believe that further unknown risk factors might influence the mortality, especially in patients with SCI.

show abstract

The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: A tool for distinguishing necrotizing fasciitis from other soft tissue infections*

Cited by 1,249 publications

References 21 publications

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

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

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

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

Contact Info

Product

Resources

About