A prospective study to assess the prognosis of patients with necrotizing fasciitis using laboratory risk indicator for necrotizing fasciitis (LRINEC) scoring system in a tertiary care hospital.

INTRODUCTION

Necrotizing fasciitis (NF) is a rare but potentially fatal infection, involving the subcutaneous tissue and fascia. The incidence of NF worldwide ranges from 0.30 to 15 cases per 100,000 populations and mortality remains high at 25 %.

OBJECTIVES

To classify severity of necrotizing fasciitis and assess the prognosis of necrotizing fasciitis using the LRINEC Scoring system.

METHODS

A thorough history and detailed clinical examination was done. Patient underwent necessary investigations like hemoglobulin, total leukocyte count, serum sodium, serum creatinine, random blood sugar, and C-reactive protein. Based on the investigations, two groups were formulated, LRINEC score <6 (low risk) and ≥6 (high risk). Then prognosis was assessed. The results were compared between the two groups.

RESULTS

In our study, a total of 124 patients were included with 62 of them with LRINEC score of <6 and 62 patients with LRINEC score ≥6. The sensitivity and specificity for predicting the septic shock and mortality with LRINEC score is 94 % and 70 % and 94 % and 71 %, respectively.

CONCLUSIONS

LRINEC score is a simple clinical tool for predicting the prognostic outcomes in patients with necrotizing fasciitis. LRINEC score of ≥6 have poorer prognosis in the form septic shock and eventual mortality.