How Far The Laboratory Risk Indicator For Necrotizing Fascitis (Lrinec) Score Validate For Early Diagnosis of Necrotizing Fascitis
How Far The Laboratory Risk Indicator For Necrotizing Fascitis (Lrinec) Score Validate For Early Diagnosis
DOI:
https://doi.org/10.70284/njirm.v8i6.1321Keywords:
Necrotizing fasciitis, LRINEC score, Infections, DebridementAbstract
Introduction: Necrotizing fasciitis (NF) is a rapidly progressive infection primarily involving the fascia and subcutaneous tissue. It describes a group of relatively uncommon, but life-threatening infections of the skin, soft tissues, and muscles, which tend to progress rapidly through the fascial planes, causing rapid destruction of the fascial planes. It is a surgical emergency which requires immediate wide surgical debridement and patients to be kept on broad-spectrum antibiotics. Aim & Objective: To study validation of the laboratory risk indicator for necrotizing fasciitis (LRINEC) score for early diagnosis of necrotizing fasciitis and study its validation with the help of parameters like C-reactive protein, Total WBC count, Hemoglobin Serum sodium, Serum creatinine and Blood glucose. Methods: A prospective observational study over a period of one year in which a total of 69 patients of necrotizing fasciitis were studied and are correlated with LRINEC score. Results: The median age of the patients was 48.4 years, out of which 46 patients were male and 23 patients were female. The present study shows that out of 69 patients 42 patients (60.87%) had an LRINEC score more than 6. Conclusion: LRINEC scoring system is a valid diagnostic tool for early diagnosis of necrotizing fasciitis, but it should also be kept in mind that if the LRINEC score comes to be less than six than it should not be excluded. Emphasis must remain on expert clinical diagnosis and judgment in order not to delay surgical treatment as well as the use of the multidisciplinary team. [Alok R NJIRM 2017; 8(6):4-7]
References
2. Elliott DC, Kufera JA, Myers RA. Necrotizing soft tissue infections. Risk factors for mortality and strategies for management. Annals of surgery. 1996; 224(5):672.
3. McHenry CR, Piotrowski JJ, Petrinic D, Malangoni MA. Determinants of mortality for necrotizing soft-tissue infections. Annals of surgery. 1995; 221(5):558.
4. Bilton BD, Zibari GB, McMillan RW, Aultman DF. Aggressive surgical management of necrotizing fasciitis serves to decrease mortality: a retrospective study/discussion. The American Surgeon. 1998; 64(5):397.
5. Moss RL, Musemeche CA, Kosloske AM. Necrotizing fasciitis in children: prompt recognition and aggressive therapy improve survival. Journal of pediatric surgery. 1996;31(8):1142-6.
6. Wong C-H, Khin L-W, Heng K-S, Tan K-C, Low C-O. The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score a tool for distinguishing necrotizing fasciitis from other soft tissue
infections. Critical care medicine. 2004; 32(7):1535-41.
7. Maya SP, Beltrán DD, Lemercier P, Leiva-Salinas C. Necrotizing fasciitis: an urgent diagnosis. Skeletal radiology. 2014; 43(5):577-89.
8. Loyer EM, DuBrow RA, David CL, Coan JD, Eftekhari F. Imaging of superficial soft-tissue infections: sonographic findings in cases of cellulitis and abscess. AJR American journal of roentgenology. 1996;166(1):149-52.
9. Williams N, O'Connell PR. Bailey & Love's Short Practice of Surgery 26E: Crc Press; 2013.
10. Borschitz T, Schlicht S, Siegel E, Hanke E, von Stebut E. Improvement of a clinical score for necrotizing fasciitis: ‘pain out of proportion ‘and high CRP levels aid the diagnosis. PloS one. 2015; 10(7):e0132775.
11. Karkas A, Chahine K, Schmerber S, Brichon PY, Righini C. Optimal treatment of cervical necrotizing fasciitis associated with descending necrotizing mediastinitis. British Journal of Surgery. 2010;97(4):609-15
12. Edlich RF, Cross CL, Dahlstrom JJ, Long WB. Modern concepts of the diagnosis and treatment of necrotizing fasciitis. The Journal of emergency medicine. 2010; 39(2):261-5.
13. Magala J, Makobore P, Makumbi T, Kaggwa S, Kalanzi E, Galukande M. The clinical presentation and early outcomes of necrotizing fasciitis in a Ugandan Tertiary Hospital-a prospective study. BMC research notes. 2014; 7(1):476.
14. Misiakos EP, Bagias G, Patapis P, Sotiropoulos D, Kanavidis P, Machairas A. Current concepts in the management of necrotizing fasciitis. Frontiers in surgery. 2014; 1.
15. Shiroff AM, Herlitz GN, Gracias VH. Necrotizing soft tissue infections. Intensive Care Med. 2014; 29:138–44.
