Study of the utility of the laboratory risk indicator for necrotizing fasciitis （LRINEC） score for necrotizing fasciitis in the head and neck region

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  • KUSUMOTO Junya
    Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine
  • FURUDOI Shungo
    Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine
  • SAKAKIBARA Akiko
    Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine
  • HATA Midori
    Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine
  • AKASHI Masaya
    Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine
  • KOMORI Takahide
    Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine

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Other Title
  • 頭頸部領域における壊死性筋膜炎に対する LRINEC score の有用性の検討
  • アタマ ケイブ リョウイキ ニ オケル エシセイキンマクエン ニ タイスル LRINEC score ノ ユウヨウセイ ノ ケントウ

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Necrotizing fasciitis is a rare, but lethal disease. This disease requires prompt surgical debridement of the necrotic tissue. However, it is often difficult to differentiate early-onset necrotizing fasciitis from cellulitis and abscess. The laboratory risk indicator for necrotizing fasciitis （LRINEC） score was introduced as a tool for the early recognition and diagnosis of necrotizing fasciitis. There have been several reports on the utility of the LRINEC score in the extremities and trunk, but only one report on the head and neck region. We therefore retrospectively investigated the utility of the LRINEC score for necrotizing fasciitis in the head and neck region. The subjects were 10 patients with necrotizing fasciitis and 86 patients with severe cellulitis. The LRINEC score was significantly higher in patients with necrotizing fasciitis （mean 7.0 points, range 0-10） than in those with severe cellulitis （mean 1.9 points, range 0-10). A LRINEC score of ≥6 had a sensitivity of 90.0%, a specificity of 88.4%, a positive predictive ratio of 47.4%, and a negative predictive ratio of 98.7%. Our results suggested that the LRINEC score is a valuable auxiliary diagnostic tool, especially for the exclusive diagnosis of necrotizing fasciitis in the head and neck region.

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