Use of Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score in Early Diagnosis of Necrotizing Fasciitis in a Tertiary Health Care Center in Mangalore

Abstract

Background: Necrotizing fasciitis (NF) is a life-threatening soft tissue infection
requiring early diagnosis and intervention to reduce morbidity and mortality. The
Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score is a diagnostic
tool to differentiate NF from other soft tissue infections.
Objective: To assess the efficacy of the LRINEC score in the early diagnosis of NF
and its ability to distinguish NF from other soft tissue infections.
'Methods: A prospective observational study was conducted at Father Muller
Medical College, Mangalore, involving 80 patients aged 18–70 years with soft tissue
infections. The LRINEC score was calculated based on laboratory parameters,
including C-reactive protein, white blood cell count, hemoglobin, sodium, creatinine,
and glucose levels. Patients were followed up, and outcomes were analyzed using
sensitivity, specificity, and chi-square tests (p<0.05).
Results: Of the 80 patients, 64 were male, with a mean age of 58.47 years (SD
±9.05). The LRINEC score ≥6 had a sensitivity of 97.30% and specificity of 97.67%
for NF diagnosis. Clinical judgment showed 100% sensitivity and 89.36%
specificity. Diabetes mellitus was present in 56.25% of cases, and trauma was the
leading etiology (50%). Intervention was required in 52.50% of cases.
Conclusion: The LRINEC score ≥6 is highly sensitive and specific for early NF
diagnosis, supporting its use in clinical practice.