scholarly journals LABORATORY RISK INDICATOR FOR NECROTIZING FASCIITIS (LRINEC) SCORE FOR THE ASSESSMENT OF NECROTIZING FASCIITIS IN HIMALAYAN REGION.

2021 ◽  
Vol 5 (10) ◽  
Author(s):  
Jeevan Kumar ◽  
Ramesh Bharti ◽  
Amar Verma ◽  
Rajesh Sharma
Keyword(s):  
Necrotizing Fasciitis ◽  
Early Recognition ◽  
Risk Indicators ◽  
Risk Indicator ◽  
Medical College ◽  
Reactive Protein ◽  
Lrinec Score ◽  
One Year ◽  
Time Of Admission ◽  
Severe Soft Tissue

Background: The LRINEC score (laboratory risk indicators for necrotizing fasciitis) was established in 2004 to aid in the differentiation of necrotizing fasciitis from severe soft tissue infections. Methods: The study included all patients hospitalized to the department of general surgery at Dr. Rajendra Prasad Govt. Medical College & Hospital, Kangra, Tanda, H.P. India with a diagnosis of necrotizing fasciitis for a period of one year, from June 2018 to May 2019. At the time of admission, the patient’s hemoglobin, white blood cell count, C-reactive protein, blood glucose level, urea, sodium, potassium and creatinine levels (LIRNEC Score) were calculated. Results: In all the patients LRINEC Score was > 6. Out of 60 patients, 14(23%) patients had LRINEC Score in between 6 to 7 and 46 (76%) patients had LRINEC score >8. Conclusion: The LRINEC score of 6 and above suggest NF and therefore aiding in the early recognition of NSTI and its management.

scholarly journals Correlation of the laboratory risk indicators for necrotizing fasciitis (LRINEC) score with the clinical features and surgical management of necrotizing soft tissue infections

2018 ◽  
Vol 5 (10) ◽  
pp. 3394
Author(s):  
Neeraj Kumar ◽  
Raghav Garg ◽  
Rajesh Kumar Soni ◽  
Ratnakar Namdeo
Keyword(s):  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Clinical Features ◽  
Surgical Management ◽  
Risk Indicators ◽  
Risk Indicator ◽  
Necrotizing Soft Tissue Infections ◽  
Lrinec Score ◽  
Poor Outcomes ◽  
Time Of Admission

Background: Necrotizing 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 correlate the clinical features of NSTI with the LRINEC score, its application to distinguish Necrotizing Fasciitis (NF) from other non NSTI and its utility in early surgical management of NSTI.Methods: Patients were evaluated for various symptoms and signs at the time of admission and certain laboratory parameters were assessed. LRINEC score was then calculated. Correlation of the management and severity of infections with respective LRINEC score was then found out.Results: LRINEC score for predicting conservative management of NSTI has a sensitivity of 81.8% and specificity of 98% while for predicting amputation and mortality shows a sensitivity of 100% and specificity of 84.5%.Conclusions: The LRINEC score is a robust score capable of detecting even clinically early cases of necrotizing fasciitis.

scholarly journals Validation of LRINEC (Laboratory Risk Indicators for Diagnosis of Necrotizing Fasciitis) Scoring System for the Diagnosis of Necrotizing Fasciitis

2020 ◽  
Vol 23 (2) ◽  
pp. 75-80
Author(s):  
Md Nur Alam Mohim ◽  
MA Hashem Bhuiya ◽  
AZM Mahfuzur Rahman ◽  
Md Mahmudul Islam ◽  
Masfique Ahmed Bhuiya
Keyword(s):  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Early Recognition ◽  
Subcutaneous Tissue ◽  
Risk Indicators ◽  
Soft Tissue Infections ◽  
Predictive Values ◽  
Lrinec Score ◽  
Surgery Department ◽  
Severe Soft Tissue

Background : Necrotizing fasciitis (NF) is a rare but potentially fatal infection involving the subcutaneous tissue and fascia. Different classifications and terminology has been used in NF based on affected anatomy, microbial cause and depth of infection. Clinical scores like the laboratory risk indicators for NF (LRINEC) scores are available to help diagnose NF and differentiate it from other skin and soft tissue infections. Methods : A total of 100 patients were included in the study between January 2014 to June 2014. This prospective study was done on patients admitted in surgery department of DMCH with symptoms suggestive of soft tissue infections during the study period. Results : Mean age was found 46.5(±13.8) years in severe cellulitis and 50.9(±9.8) years in necroting fasciitis (p>0.05). Male were predominant (60%). 80% of NF had DM. The validation test for LRINEC score e”6 vs necrotizing fasciitis had sensitivity of 66%, specificity 84%, accuracy 75%, positive and negative predictive values were 80.49% and 71.19% respectively. Mortality of NF was 6%. Conclusion : The LRINEC score is an impressive diagnostic tool to distinguish necrotizing fasciitis from other severe soft tissue infections, but it is not useful for early recognition of necrotizing fasciitis. Journal of Surgical Sciences (2019) Vol. 23(2): 75-80

scholarly journals The clinical efficacy of laboratory risk indicator for necrotizing fascitis score in early diagnosis of patients with necrotizing fascitis

2021 ◽  
Vol 8 (7) ◽  
pp. 2133
Author(s):  
Murakonda Sowmya Chowdary ◽  
Srinivasan D. ◽  
Sreeramulu P. N. ◽  
Tejaswini M. Pawar ◽  
Krishna Prasad K.
Keyword(s):  
High Risk ◽  
Mortality Rate ◽  
Necrotizing Fasciitis ◽  
Early Recognition ◽  
Subcutaneous Tissue ◽  
Lower Limbs ◽  
Risk Indicator ◽  
Icu Stay ◽  
Necrotizing Fascitis ◽  
Lrinec Score

Background: Necrotizing fasciitis is a rare, rapidly progressive infection which causes extensive necrosis of the fascia and subcutaneous tissue. Early recognition and debridement are major prognostic determinants, and delay has been shown to increase mortality rate. We describe a novel, simple, and objective scoring system, the laboratory risk indicator for necrotizing fasciitis (LRINEC) score, based on routine laboratory investigations readily available at most centres, that can help to distinguish necrotizing fasciitis (nec fasc) from severe cellulitis or abscess.Methods: We performed a single centre, retrospective, all patients treated at the RLJ Hospital for necrotizing fasciitis between January 2017 and December 2019 were included in this study. The outcome of the study was based on comparing LRINEC score and Wang and Wong staging, which is useful to detect necrotizing fasciitis severity.Results: In our study, males were predominantly affected more common in lower limbs followed by perineum and abdominal wall in their fifties with diabetes mellitus and hypertension as dominant co-morbid diseases. In the study among subjects with high risk score, 83.3% required ICU stay, among subjects with moderate risk, 16.7% required ICU stay and among subjects with low risk, 12.5% required ICU stay.Conclusions: All patients with higher LRINEC scores and who were classified as ‘high risk’ in Wang and Wong classification required ICU stay and significant association with mortality rate.

scholarly journals Necrotizing fasciitis of the upper back presenting with left shoulder pain

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Mohamad Zikri Mohamad Isa ◽  
Mohamed-Syarif Mohamed-Yassin ◽  
Roqiah Fatmawati Abdul Kadir
Keyword(s):  
Necrotizing Fasciitis ◽  
Shoulder Pain ◽  
Soft Tissues ◽  
Protein A ◽  
Subcutaneous Fat ◽  
Left Shoulder ◽  
Risk Indicator ◽  
Reactive Protein ◽  
Cell Counts ◽  
Lrinec Score

Necrotizing fasciitis is a severe and progressive infection of deep soft tissues which results in destruction of the fascia and overlying subcutaneous fat. We report a case of a 45-year-old diabetic gentleman who initially presented with left shoulder pain, which was treated symptomatically. Upon representation, he had fever and the pain extended to his left upper back. There was a warm, firm and mildly tender purplish swelling on his mid to the left upper back. Blood tests revealed significantly elevated white cell counts and C-reactive protein. A CT thorax showed extensive soft tissue gas within the deep and superficial fascial layers of his left upper back. Necrotizing fasciitis was confirmed intraoperatively. The diagnosis of this condition is often difficult as early symptoms can be mild and nonspecific. A high Laboratory Risk Indicator for NECrotizing fasciitis (LRINEC) score may be helpful to rule in this diagnosis and guide further management.

scholarly journals Laboratory risk indicator for necrotising fasciitis [LRINEC] score as a tool for differentiating necrotising fasciitis from other soft tissue infections

2021 ◽  
Vol 38 (4) ◽  
pp. 571-576
Author(s):  
Raghunatha REDDY ◽  
Purushothaman RANGASWAMY ◽  
Preetham RAJ ◽  
Chandrakant KESARI ◽  
Ganesh SAGAR
Keyword(s):  
High Risk ◽  
Soft Tissue ◽  
High Risk Group ◽  
Necrotising Fasciitis ◽  
Risk Indicator ◽  
Soft Tissue Infections ◽  
College Hospital ◽  
Medical College ◽  
Lrinec Score ◽  
Severe Soft Tissue

Necrotizing fasciitis (NF) is often fatal, characterized by extensive necrosis of the subcutaneous tissues and fascia. The present study was aimed to validate the Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) score as a tool to predict/diagnose NF and to differentiate it from other soft tissue infections depending on the score. A Prospective Observational study was conducted in ESICMC PGI MSR, Medical College Hospital, Rajajinagar, Bengaluru, from Jan 2019 to June 2020. Patients ≥18 years of age with severe soft tissue infections were included in the study. Based on the LRINEC score, the patients were categorised as low (≤5), moderate (6-7) and high risk (≥8) for the prediction of onset or diagnosis of NF. Data analysis was performed using SPSS version 21.0. A total of 55 patients were included in the study. A significant 3 association was observed Dweitpharatgmee(npt=o0f.0X4X2)X, ,LURnINivEerCsitsycorfeX(pX=X0,.0X0X01X),TCraRineiancgtiavnedPRroetseianrc(hCRHPo;spi=ta0l.,0C00it1y),,Choauenmtroyglobin (p=0.008), serum 4 sodium levels (p=0.004), serum creatinine (0.D00e1p)a,ratmndenatmopfuXtaXtiXon, F(pac=u0l.t0y0o4f).XAXmXp,uCtaityio,nCwouanstdryone in 5 cases. Only 1 mortality was observed in LRINEC high risk group with NSSTI. To conclude, LRINEC scoring system showed a better positive predictive value in identifying the onset of NF and risk strategizing of the patients with severe soft tissue infections.

scholarly journals Prospective Validation of the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score for Necrotizing Fasciitis of the Extremities

PLoS ONE ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. e0227748 ◽  
Author(s):  
Cheng-Ting Hsiao ◽  
Chia-Peng Chang ◽  
Tsung-Yu Huang ◽  
Yi-Chuan Chen ◽  
Wen-Chih Fann
Keyword(s):  
Necrotizing Fasciitis ◽  
Risk Indicator ◽  
Lrinec Score

scholarly journals Necrotizing fasciitis with prior leprosy: a case report

2020 ◽  
Vol 6 (6) ◽  
pp. 788
Author(s):  
Vannia C. Teng ◽  
Prima K. Esti ◽  
Sweety Pribadi
Keyword(s):  
Case Report ◽  
Necrotizing Fasciitis ◽  
Limited Resource ◽  
Masking Effect ◽  
Risk Indicator ◽  
Broad Spectrum Antibiotic ◽  
Life Threatening ◽  
Lrinec Score ◽  
Improve Patient Management ◽  
Improve Patient

<p class="abstract">Necrotizing fasciitis (NF) is a life-threatening soft tissue infection with a high misdiagnosis rate. Here, we present the case of NF with hypoesthesia due to prior leprosy in a limited resource area. Laboratory risk indicator for NF (LRINEC) score was used to determine the diagnosis of NF. Resuscitation and broad-spectrum antibiotic were initiated, followed by surgical debridement due to lack of wound improvement and skin graft to cover the wound was done. This case report highlights the usage of LRINEC score to reduce misdiagnosis, ensure early diagnosis, and improve patient management in NF with masking effect.</p>

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