Shireen A A Ramzanali Damani, Khalid Rasheed.
LRINEC Score ? a Reliable Diagnostic Tool for Early Diagnosis of Necrotizing Fasciitis.
J Surg Pak Jan ;22(2):43-6.

Objective: To evaluate the reliability of LRINEC (Laboratory Risk Indicator For Necrotizing Fasciitis) score for clinical diagnosis of necrotizing fasciitis (NF). Study design: Retrospective review of records. Place & Duration of study: Department of General Surgery ward 26, Jinnah Postgraduate Medical Center (JPMC) Karachi, from December 2010 to November 2015. Methodology: The diagnosis of NF was made on the clinical grounds followed by confirmation on surgical intervention by the presence grey necrotic tissues, absence of dermal bleeding and foul smelling dish water color pus. The LRINEC score was applied. Patients were excluded from study if they were of age < 15 or >90 year and patients transferred from other hospitals after the initial treatment. Results: The LRINEC score calculated and all the patients were divided into two groups. One group with LRINEC > 6 included 27 patients while the other group with LRINEC score < 6 included 13 patients. The diagnosis of NF was confirmed on histopathology of tissue sample taken during the first debridement. Histopathology revealed that 23 out of 27 patients with LRINEC >6 and 4 out of 13 patients with LRINEC score <6 had positive histopathology for NF. LRINEC score was found to be 92.15% sensitive (CI; 95%) and 90.70% specific (CI; 95%) with positive and negative predictive value (PPV and NPV) of 95.45% and 85.33% respectively. Conclusion: The diagnostic yield of LRINEC scoring system for necrotizing fasciitis was high. It was easy to apply and cost effective.

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