Use of Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score in differentiating Necrotising Fasciitis cases from Soft tissue infections: A Prospective Study

ABSTRACT

Background: Necrotising fasciitis is a progressive, fulminant, inflammatory infection of deep fascia with secondary necrosis of subcutaneous tissue. The present study was carried out to evaluate the usefulness of LRINEC score to differentiate Necrotising fasciitis (NF) from other soft tissue infections (STI). Methods: Ours was a prospective observational study carried out in a tertiary care setting over a period of one year from November 2013 to November 2014. 150 patients of soft tissue infections were included. Clinical evaluation was done based on the signs and symptoms which included a rapidly progressive oedema, bullae, blue-grey cyanotic lesions, erythema and necrotic patches. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score including Haemoglobin count, Total leucocyte count, C - reactive protein, Platelet count, Fasting blood sugar and Serum sodium, was calculated for all the patients. Results: Among 150 patients with soft tissue infection, 108 (72%) patients were clinically proven to be NF, rest 42(28%) were soft tissue infections. Based on LRINEC score out of 42 STI, 15 % had moderate to high risk of NF while out of the 108 confirmed NF cases 55 % had low to moderate risk of NF. Conclusion: The low sensitivity and low positive predictive value achieved in this study as well as other studies makes the LRINEC score unsuitable to be used solely to distinguish NF with other soft tissue infections