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 Laboratory risk indicator for necrotizing fasciitis: an objective scoring system as a tool for early diagnosis of necrotizing fasciitis

2021 ◽  
Vol 9 (1) ◽  
pp. 102
Author(s):  
Syed Saad ◽  
Panchami P. ◽  
Gulamnabi .
Keyword(s):  
High Risk ◽  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Scoring System ◽  
Risk Group ◽  
High Risk Group ◽  
Intermediate Risk ◽  
Soft Tissue Infections ◽  
Necrotizing Soft Tissue Infections ◽  
Lrinec Score

Background: Necrotizing soft tissue infections are often fatal, characterized by extensive necrosis of the subcutaneous tissues and fascia. The mortality of 30-40% reflects the inadequacy of early recognition of necrotizing soft tissue infections. This study emphasizes on the search for a tool that reliably and rapidly identifies patients with NF. An objective of current study was to validate the LRINEC score as a tool for early distinguishing of necrotizing fasciitis from other soft tissue infections.Methods: Prospective clinical study analysis of outcome of sixty of patients with soft tissue infections were evaluated based on LRINEC. Based on their LRINEC score, the patients were categorized as low, intermediate and high risk for the onset of necrotizing fasciitis.Results: A total of 60 patients with soft tissue infections were prospectively evaluated and categorized on the basis of LRINEC score 45 patients in low risk category, 7 in Intermediate risk and 8 patients in high risk group. In terms of outcome, all cases (including positive tissue diagnosis cases) in low risk and intermediate risk groups and 2 cases in high risk group were improved with surgical debridement/fasciotomy. The cutoff of LRINEC ≥6 has better sensitivity and specificity in identifying the risk of the patient.Conclusions: LRINEC scoring system has a better positive predictive value in identifying the onset and risk strategizing of necrotizing fasciitis.

scholarly journals Necrotizing Soft-Tissue Infection: Laboratory Risk Indicator for Necrotizing Soft Tissue Infections Score

2014 ◽  
Vol 6 (01) ◽  
pp. 046-049 ◽  
Author(s):  
Madhuri Kulkarni ◽  
Vijay Kumar GS ◽  
Sowmya GS ◽  
Madhu CP ◽  
Ramya SR
Keyword(s):  
Soft Tissue ◽  
Immunocompromised Host ◽  
High Morbidity ◽  
Risk Indicator ◽  
Soft Tissue Infections ◽  
Acinetobacter Species ◽  
Mortality And Morbidity ◽  
Necrotizing Soft Tissue Infections ◽  
Lrinec Score ◽  
Immunocompromised Hosts

ABSTRACTNecrotizing soft tissue infections (NSTI) can be rapidly progressive and polymicrobial in etiology. Establishing the element of necrotizing infection poses a clinical challenge. A 64-year-old diabetic patient presented to our hospital with a gangrenous patch on anterior abdominal wall, which progressed to an extensive necrotizing lesion within 1 week. Successive laboratory risk indicator for necrotizing softtissue infections (LRINEC) scores confirmed the necrotizing element. Cultures yielded Enterococci, Acinetobacter species and Apophysomyces elegans and the latter being considered as an emerging agent of Zygomycosis in immunocompromised hosts. Patient was managed with antibiotics, antifungal treatment and surgical debridement despite which he succumbed to the infection. NSTI’s require an early and aggressive management and LRINEC score can be applied to establish the element of necrotizing pathology. Isolation of multiple organisms becomes confusing to establish the etiological role. Apophysomyces elegans, which was isolated in our patient is being increasingly reported in cases of necrotizing infections and may be responsible for high morbidity and mortality. This scoring has been proposed as an adjunct tool to Microbiological diagnosis when NSTI’s need to be diagnosed early and managed promptly to decrease mortality and morbidity, which however may not come in handy in an immunocompromised host with polymicrobial aggressive infection.

scholarly journals Study of the effectiveness of laboratory risk indicator for necrotizing fasciitis scoring system in the diagnosis of necrotizing fasciitis among patients presenting with soft tissue infections

2021 ◽  
Vol 8 (7) ◽  
pp. 2041
Author(s):  
Shreeniketan Nayak ◽  
Prakash S. Kattimani
Keyword(s):  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Soft Tissue Infection ◽  
Scoring System ◽  
Tissue Infection ◽  
Risk Indicator ◽  
Soft Tissue Infections ◽  
Predictive Values ◽  
Necrotizing Soft Tissue Infection ◽  
Lrinec Score

Background: Necrotizing soft tissue infection (NSTI) is an uncommon but life threatening disease with a high mortality rate. Delay in diagnoses and in surgery for debridement is associated with increased mortality rates. Hence here we would like to use this scoring system - laboratory risk indicator for necrotizing fasciitis (LRINEC) in patients presenting to our hospital with necrotizing soft tissue infection and if found to have good predictive values, it would be a boon to developing countries like India where the mortality of the disease is high (7% to 76%).Methods: Patients presenting with symptoms suggestive of soft tissue infection underwent clinical examination and basic laboratory investigations. Following which, information collected using semi structured proforma cum observational checklist. LRINEC scoring system applied to each of the study subjects at admission. The confirmatory diagnosis of necrotizing fasciitis done on patients who undergo surgery vide histopathology, irrespective of the result of the LRINEC scoring system. Tissue cultures and sensitivity patterns analyzed.Results: A total of 100 patients were enrolled. LRINEC score has an ability to diagnose necrotizing fasciitis from other soft tissue infections. High LRINEC score had more incidences of features of sepsis. Presence of the co morbidities tended to increase the LRINEC score. And defines patients with a high LRINEC score of >8 had higher mortality rate.Conclusions: LRINEC score is a simple clinical tool for the diagnosis of necrotizing fasciitis from other soft tissue infections. LRINEC scoring system and clinical assessment should be used concurrently for diagnosing necrotizing fasciitis from other soft tissue infections.

scholarly journals A study on role of laboratory risk indicator for necrotizing fasciitis score in necrotizing fasciitis

2019 ◽  
Vol 6 (11) ◽  
pp. 3901
Author(s):  
Narendra Prasad Narsingh ◽  
Anjana Nigam ◽  
Ramesh Kumar
Keyword(s):  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Soft Tissue Infection ◽  
Age Groups ◽  
Clinical Findings ◽  
High Risk Group ◽  
Tissue Infection ◽  
Risk Indicator ◽  
Early Management ◽  
Lrinec Score

Background: Necrotizing fasciitis (NF) represents a group of highly lethal infection characterized by rapidly progressing inflammation and necrosis. The spectrum of disease ranges from necrosis of the skin to life threatening infection. Laboratory risk indicator for necrotizing fasciitis (LRINEC) score is only scoring system available so far to help us towards making an early and accurate diagnosis.Methods: The current prospective observational study was conducted in the Surgery OPD and emergency, Department of surgery, Dr. B.R. Ambedkar Memorial Hospital, Raipur, CG, India, during study period October 2017 to September 2018. Sample size was fixed at 100. Blood tests taken on admission were used to calculate the LRINEC score in each case.Results: In this study 55% of patients with soft tissue infections were categorized as low risk for progression of NF. Necrotizing soft tissue infection (NSTI) occurs in all age groups, ranging from 18 to 75 years. Clinical findings of crepitus were found in 33% of all patients of NSTI. 96% of the patients underwent debridement once, debridement was done twice in 3% of the patients while debridement was not done in 1% of the patients who belonged to high risk group and had no comorbidities. Out of 100, 3 patients underwent amputation. We found that there is mortality rate of 5%.Conclusions: NF was most severe form of soft tissue infection, potentially life and limb threatening. Early diagnosis of NF is essential for early management and better prognosis of patients.

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 LRINEC: an economical diagnostic tool for prognosis in patients with necrotizing soft tissue infections in a tertiary care centre

2019 ◽  
Vol 6 (6) ◽  
pp. 2007
Author(s):  
Ballapalli Hari Prasad ◽  
Minchala Chengalrayan Narendra ◽  
Shaik Nurul Hameed
Keyword(s):  
Soft Tissue ◽  
Tertiary Care ◽  
Lower Limbs ◽  
Soft Tissue Infections ◽  
Tertiary Care Centre ◽  
Female Ratio ◽  
Medical College ◽  
Necrotizing Soft Tissue Infections ◽  
Lrinec Score ◽  
A Prospective Study

Background: The objective of the study was to evaluate the efficacy of LRINEC score in the management and prognosis of patients with soft tissue necrotizing infections.Methods: This is a prospective study conducted in Sri Padmavathi Medical College (W), Tirupati, Andhra Pradesh, India from May 2018 to January 2019. It included 50 patients who were diagnosed with severe soft tissue infection of lower limbs who needed surgical intervention. The effectiveness of LRINEC score was determined from the outcome.Results: Age group varied from 40 to 60 years. Out of 50 patients 40 were men and 10 were women. The male to female ratio was 4:1. All the patients were investigated at the time of admission in the emergency department using the LRINEC score. Hospital stay varied from 15-45 days.Conclusions: This study concludes that LRINEC score is an economical and accurate investigating tool in necrotizing soft tissue infections to determine the prognosis and outcomes. 

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

Sign in / Sign up

Export Citation Format

Share Document