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

Introduction: Necrotizing fasciitis (NF) 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. Aim: The study aimed to investigate and quantify the relationships between the LRINEC scoring system and the outcomes such as the need for amputation, length of hospital stay, and mortality in patients with necrotizing fasciitis. Material and methods: 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 the LRINEC score. The differences in mortality, length of hospitalization, number of debridement procedures, and need for amputation between these groups were compared. Results: Increasing age, male gender, and DM have a poor prognosis in necrotizing fasciitis patients. The amputation and mortality rates are better correlated with higher LRINEC scores. Conclusions: The LRINEC score helps in stratifying the patients into three risk categories (low risk, moderate risk, and high risk) according to the severity in a much more organized way, and thus the appropriate management like surgical debridement can be introduced on time. 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 outcomes in patients with necrotizing fasciitis.