To Study Effectiveness of Lrinec (Laboratory Risk Indicator For Necrotizing Fasciitis) Scoring System In The Diagnosis Of Necrotizing Fasciitis Among Patients Presenting With Soft Tissue Infections.

Abstract

AIMS & OBJECTIVES To study effectiveness of LRINEC (Laboratory risk indicator for necrotizing fasciitis) scoring system in the diagnosis of Necrotizing Fasciitis among patients presenting with soft tissue infections. MATERIALS AND METHODS:- This is a prospective observational study of 180 patients presented with soft tissue infections in B.L.D.E (DU)’S Shri B.M.Patil Medical College and were divided into three risk groups – Low, Intermediate and High, based on LRINEC scores. Results:- Out of 180 patients, 60-69 years age group was predominant (20.6 %) in the present study. The male participants were almost three-fold higher than females. DM has major co morbid present among the patients. Patients were grouped into 115 (63.9%) Low risk, 39 (21.7%) Intermediate, 26(14.4%) High risk groups. Mann Whitney U test was used to compare treatment modalities and found statistical significance. The mean ±SD of surgical intervention was lower than conservative management. Conservative management in low risk group was predominant (96.5%). But, both moderate (69.2%) and high risk (86.2%) groups had surgical intervention as a predominant treatment strategies. However, conservative treatment has also been observed in these moderate (30.8%) and high risk (3.8%) groups. Using Spearman’s correlation coefficient, Age of the total participants was compared with LRINEC Score and found insignificant. The high-risk group (LRINEC score ≥8) has higher sensitivity (95.83 %) and specificity (100 %) than the intermediate risk group (LRINEC score 6-7) has moderate sensitivity (74.07 %) & specificity of 100% and Low-risk group (LRINEC score ≤5) has lower sensitivity (20 %) & specificity of 100%. The LRINEC score more than i.e. two groups (6-7 & ≥8) showed significant diagnostics accuracy for Necrotizing Fasciitis. Conclusion: - LRINEC Score is useful tool for clinical diagnosis of Necrotizing Fasciitis from other soft tissue infections.