Prognostic Value of Laboratory Risk Indicators of Necrotizing Fasciitis Score in Necrotizing Fasciitis

Abstract

Necrotizing fasciitis is a potentially life-threatening infection of subcutaneous tissues and skin. Laboratory risk indicators of necrotizing fasciitis (LRINEC) score are based on the results of routinely performed laboratory investigations. A prospective study was conducted at tertiary care hospital between December 2018, and September 2020, to find out the correlation of LRINEC score with severity and outcome in the cases of necrotizing fasciitis. LIRNEC score was also corelated with serum procalcitonin level at the time of admission. Blood investigations included in LRINEC score [Hemoglobin (g/dL), WBC count (thousand per mm3), CRP (mg/dL), Serum Creatinine (mg/dL), Blood Glucose (mg/dL) & serum Sodium (mEq/L)] were done at the time of admission. At the same time, serum procalcitonin level was also ordered. Detailed history and examination findings were recorded. Aggressive management was started soon after the admission of patient.
Based on the LRINEC score, patients were categorized in three risk categories namely low risk, intermediate risk and high risk. In our study, 45% patients were in low risk, 27% in intermediate risk and 28% in high-risk categories. Mean age of presentation was 53.17 years. Most common co-morbidity was diabetes mellitus (36%). Most common site involved was lower limbs (75%). Mortality rate was more than 32% in patients with LRINEC score ≥8. In our study serum procalcitonin levels were proportionate to LRINEC score.
Conclusion: The LRINEC score very well correlates with severity of necrotizing fasciitis and it can be used as a Prognostic indicator.