Early Diagnosis Using the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score

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  • 壊死性筋膜炎の診断・予後評価におけるLaboratory Risk Indicator for Necrotizing Fasciitis（LRINEC）scoreの有効性
  • エシセイキン マクエン ノ シンダン ヨゴ ヒョウカ ニ オケル Laboratory Risk Indicator for Necrotizing Fasciitis LRINEC score ノ ユウコウセイ

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Abstract

Early diagnosis and proper surgical debridement are important in improving the prognosis of necrotizing fasciitis. However, early diagnosis is sometimes difficult, because necrotizing fasciitis primarily involves the superficial fascia, subcutaneous fat, and deep fascia; consequently, it sometimes lacks clinical signs or symptoms during the early course of infection. The laboratory risk indicator for necrotizing fasciitis (LRINEC) score has been suggested as a convenient tool for distinguishing between necrotizing fasciitis and other soft tissue infections. The objective of this study is to evaluate the usefulness of the LRINEC score. We retrospectively assessed the LRINEC scores of 9 patients with necrotizing fasciitis and 35 patients with phlegmone at their first visit to our hospital. The LRINEC score was significantly elevated inpatients with necrotizing fasciitis (8.1±1.0 points) compared to those with phlegmone (1.7±0.3 points). When the cutoff value for the diagnosis of necrotizing fasciitis was set as 6 points, the sensitivity and specificity of the LRINEC score were 100% and 97%, respectively. Our results suggest that the LRINEC score is a useful tool for diagnosiing necrotizing fasciitis promptly, and it is simple enough for clinicians who are not skin infection specialists.

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