The Efficacy of LRINEC Scoring in Patients with Necrotizing Fasciitis and its Correlation with the Outcomes.

<b><br>Introduction:</b> Necrotizing fasciitis (NF) is an expeditiously escalating inflammatory infection of the fascia, with secondary necrosis of the subcutaneous tissues. To aid diagnosis, the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) scoring system was devised to stratify the likelihood of infection in patients on presentation.</br> <b><br>Aim:</b> The study aimed to investigate and quantify the relationships between the LRINEC scoring system and the outcomes such as the need for amputation, length of hospital stay, and mortality in patients with necrotizing fasciitis.</br> <b><br>Material and methods:</b> A total number of 90 patients were admitted with a provisional diagnosis of necrotizing fasciitis. LRINEC score was calculated for each case based on six laboratory variables at the time of presentation. Enrolled patients were divided into three groups on the basis of the LRINEC score. The differences in mortality, length of hospitalization, number of debridement procedures, and need for amputation between these groups were compared.</br> <b><br>Results:</b> Increasing age, male gender, and DM have a poor prognosis in necrotizing fasciitis patients. The amputation and mortality rates are better correlated with higher LRINEC scores.</br> <b><br>Conclusions:</b> The LRINEC score helps in stratifying the patients into three risk categories (low risk, moderate risk, and high risk) according to the severity in a much more organized way, and thus the appropriate management like surgical debridement can be introduced on time. LRINEC score is a robust index that is capable of detecting early cases of necrotizing fasciitis and is simple enough for routine use. It is a simplified bedside diagnostic tool for early diagnosis and prediction of outcomes in patients with necrotizing fasciitis.</br>.

A Prospective Study of Surgical Site Infection with its Risk Factors and Their Correlation with the NNIS Risk Index.

Background: Surgical site infection (SSI) is the third most commonly reported nosocomial infection, accounting for 10%-40% of all nosocomial infections and is a major cause of postoperative morbidity. Knowledge of factors related to SSI can help in reducing its incidence and related morbidity, which in many studies is shown to account for 38% of all infections in surgical patients. Lack of extending nosocomial infection surveillance programme and prevention measures in countries like India is viewed as a major challenge for the future. Objectives: The aims of this work were (1) to study the SSI rate in patients undergoing both elective and emergency abdominal surgery and SSI with CDC, and NNIS risk index; and (2) to assess SSI along with body mass index (BMI), glycaemic status, smoking and duration of pre-operative hospital stay of patients. Materials and Methods: In total, 300 patients who underwent elective and emergency abdominal surgery were enrolled in the study as per inclusion and exclusion criteria. SSI with CDC's NNIS risk index were analysed considering BMI, glycaemic status, smoking and duration of pre-operative hospital stay of patients. Results: In total, 300 cases of abdominal surgeries (elective and emergency) were analysed, out of which 60 cases were diagnosed to have SSI as per the criteria. Conclusion: This study demonstrated that there is a significant increase in SSI with increasing NNIS score that is, the greater the NNIS score, the greater the risk of SSI. With an increase in age, BMI, glycaemic index and preoperative hospital stay, the risk of SSI increases. Smoking and associated comorbidities also increase the risk of SSI.