Efficacy of LRINEC Scoring in Patients of Necrotizing Fasciitis and its Correlation with the Outcome

Abstract

ABSTRACTBackground: Necrotizing fasciitis 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. Objectives: Study aimed to investigate and quantify the relationships between the LRINEC scoring system and the outcomes such as need for amputation, length of hospital and mortality stay in patients with necrotizing fasciitis. Method: 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 LRINEC score. The differences in mortality, length of hospitalization, number of debridement and the need of amputation between these groups were compared. Results: Increasing age, male gender, DM has a poor prognosis in the outcome of necrotizing fasciitis patients. The amputation rates and mortality rates are better correlated with higher LRINEC score. Conclusion: The LRINEC score helps in stratifying the patients into risk categories such as low risk, moderate risk and high risk categories, according to severity in a much organized way and the appropriate management like surgical debridement can be started timely. 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 outcome in patients of necrotizing fasciitis.