Necrotizing soft tissue infections: The role of the LRINEC score

Abstract

Necrotizing fasciitis is a life-threatening soft tissue infection which requires prompt diagnosis and early debridement. This study was conducted to validate whether the LRINEC score can help in the management of Necrotizing Soft Tissue Infections (NSTI). This was a retrospective, observational study of patients admitted to our hospital with a diagnosis of NSTI. The LRINEC score was calculated for each case based on points assigned for each of the six laboratory variables at the time of patient presentation, including C-reactive protein, total white cell count, haemoglobin, serum sodium, serum creatinine and blood glucose. The study included 57 males and three females. Their ages ranged from 27-75 years, the mean age being 48.72 ± 10.16 years. The mean age among diabetic patients was slightly higher. In 37 patients, the condition was of unknown aetiology. Diabetes was the most common comorbid condition found in 19 (31.67%) patients. The wound culture was polymicrobial in all patients. Four patients died, giving a mortality of 6.67% in this study. The LRINEC score was calculated for each patient and according to the score, the patients were categorized into low-, intermediate- and high-risk groups. Notably, amputations were required only in the high-risk group. The four patients who died also belonged to the high-risk category. It was also noted in this study that patients with scrotal NSTI had a low LRINEC score compared to those with trunk and lower extremity NSTI. The LRINEC score is helpful in predicting the clinical course of NSTI and helps in taking necessary precautions to reduce the mortality of the disease.