Research Article
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Year 2021, Volume: 38 Issue: 4, 571 - 576, 09.10.2021

Abstract

References

  • Ekka, N.M.P., Kujur, A.D.S., Mishra, G., 2018. Necrotizing fasciitis: a tertiary centre based study. Int. Surg. J. 6, 233–238. https://doi.org/10.18203/2349-2902.isj20185479
  • Espandar, R., Sibdari, S.Y., Rafiee, E., Yazdanian, S., 2011. Necrotizing fasciitis of the extremities: a prospective study. Strateg. Trauma Limb Reconstr. 6, 121–125. https://doi.org/10.1007/s11751-011-0116-1
  • Falkel, J.E., 1983. Amputation as a consequence of diabetes mellitus. An epidemiological review. Phys. Ther. 63, 960–964. https://doi.org/10.1093/ptj/63.6.960
  • Wallace, H.A., Perera, T.B., 2021. Necrotizing Fasciitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430756/
  • Hakkarainen, T.W., Kopari, N.M., Pham, T.N., Evans, H.L., 2014. Necrotizing soft tissue infections: review and current concepts in treatment, systems of care, and outcomes. Curr. Probl. Surg. 51, 344–362. https://doi.org/10.1067/j.cpsurg.2014.06.001
  • Hua, J., Friedlander, P., 2021. Cervical Necrotizing Fasciitis, Diagnosis and Treatment of a Rare Life-Threatening Infection. Ear. Nose. Throat J. 145561321991341. https://doi.org/10.1177/0145561321991341
  • Kaafarani, H.M.A., King, D.R., 2014. Necrotizing skin and soft tissue infections. Surg. Clin. North Am. 94, 155–163. https://doi.org/10.1016/j.suc.2013.10.011
  • Khamnuan, P., Chongruksut, W., Jearwattanakanok, K., Patumanond, J., Tantraworasin, A., 2015. Necrotizing fasciitis: epidemiology and clinical predictors for amputation. Int. J. Gen. Med. 8, 195–202. https://doi.org/10.2147/IJGM.S82999
  • Kwan, M.K., Saw, A., Chee, E.K., Lee, C.S., Lim, C.H., Zulkifle, N.A., et.al., 2006. Necrotizing fasciitis of the lower limb: an outcome study of surgical treatment. Med. J. Malaysia 61 Suppl A, 17–20.
  • Majeski, J., Majeski, E., 1997. Necrotizing fasciitis: improved survival with early recognition by tissue biopsy and aggressive surgical treatment. South. Med. J. 90, 1065–1068. https://doi.org/10.1097/00007611-199711000-00001
  • Misiakos, E.P., Bagias, G., Papadopoulos, I., Danias, N., Patapis, P., Machairas, N., et.al., 2017. Early Diagnosis and Surgical Treatment for Necrotizing Fasciitis: A Multicenter Study. Front. Surg. 4. https://doi.org/10.3389/fsurg.2017.00005
  • Muqim, R., 2003. Necrotizing fasciitis: management and outcome. J. Coll. Physicians Surg.--Pak. JCPSP 13, 711–714. https://doi.org/12.2003/JCPSP.711714
  • Myers, C.M., Miller, J.J., Davis, W.D., 2019. Skin and Soft Tissue Infections: A Case of Necrotizing Fasciitis. Adv. Emerg. Nurs. J. 41, 322–329. https://doi.org/10.1097/TME.0000000000000268
  • Ramakrishnan, K., Salinas, R.C., Agudelo Higuita, N.I., 2015. Skin and Soft Tissue Infections. Am. Fam. Physician 92, 474–483.
  • Rampal, S., Maniam, S., Lim, P.Y., Ramachandran, R., Tan, E.K., Halim, M.A.H.A., Shamsudin, Z., Singh, S.S.S., Narayanan, P., Neela, V.K., 2021. Necrotizing fasciitis, causative agents and management: a five-year retrospective study in two tertiary care hospitals in Central Malaysia. Int. Orthop. https://doi.org/10.1007/s00264-020-04905-2
  • Schmid, M.R., Kossmann, T., Duewell, S., 1998. Differentiation of necrotizing fasciitis and cellulitis using MR imaging. AJR Am. J. Roentgenol. 170, 615–620. https://doi.org/10.2214/ajr.170.3.9490940
  • Shaikh, N., 2006. Necrotizing fasciitis: A decade of surgical intensive care experience. Indian J. Crit. Care Med. 10, 225–229. https://doi.org/10.4103/0972-5229.29840
  • Singh, G., Bharpoda, P., Reddy, R., 2015. Necrotizing Fasciitis: A Study of 48 Cases. Indian J. Surg. 77, 345–350. https://doi.org/10.1007/s12262-013-0835-2
  • Voros, D., Pissiotis, C., Georgantas, D., Katsaragakis, S., Antoniou, S., Papadimitriou, J., 1993. Role of early and extensive surgery in the treatment of severe necrotizing soft tissue infection. Br. J. Surg. 80, 1190–1191. https://doi.org/10.1002/bjs.1800800943
  • Wong, C.H., Khin, L.W., Heng, K.S., Tan, K.C., Low, C.O., 2004. The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections. Crit. Care Med. 32, 1535–1541. https://doi.org/10.1097/01.ccm.0000129486.35458.7d
  • Wysoki, M.G., Santora, T.A., Shah, R.M., Friedman, A.C., 1997. Necrotizing fasciitis: CT characteristics. Radiology 203, 859–863. https://doi.org/10.1148/radiology.203.3.9169717

Laboratory Risk Indicator for Necrotising Fasciitis [LRINEC] Score as a Tool for Differentiating Necrotising Fasciitis from other Soft Tissue Infections

Year 2021, Volume: 38 Issue: 4, 571 - 576, 09.10.2021

Abstract

Background: Necrotizing fasciitis (NF) is often fatal, characterized by extensive necrosis of the subcutaneous tissues and fascia. The present study was aimed to validate the Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) score as a tool to predict/diagnose NF and to differentiate it from other soft tissue infections depending on the score.
Methods: A Prospective Observational study was conducted in ESICMC PGI MSR, Medical College Hospital, Rajajinagar, Bengaluru, from Jan 2019 to June 2020. Patients ≥18 years of age with severe soft tissue infections were included in the study. Based on the LRINEC score, the patients were categorised as low (≤5), moderate (6-7) and high risk (≥8) for the prediction of onset or diagnosis of NF. Data analysis was performed using SPSS version 21.0.
Results: A total of 55 patients were included in the study. A significant association was observed with age (p=0.042), LRINEC score (p=0.0001), C Reactive Protein (CRP; p=0.0001), haemoglobin (p=0.008), serum sodium levels (p=0.004), serum creatinine (0.001), and amputation (p=0.004). Amputation was done in 5 cases. Only 1 mortality was observed in LRINEC high risk group with NSSTI.
Conclusion: To conclude, LRINEC scoring system showed a better positive predictive value in identifying the onset of NF and risk strategizing of the patients with severe soft tissue infections.

References

  • Ekka, N.M.P., Kujur, A.D.S., Mishra, G., 2018. Necrotizing fasciitis: a tertiary centre based study. Int. Surg. J. 6, 233–238. https://doi.org/10.18203/2349-2902.isj20185479
  • Espandar, R., Sibdari, S.Y., Rafiee, E., Yazdanian, S., 2011. Necrotizing fasciitis of the extremities: a prospective study. Strateg. Trauma Limb Reconstr. 6, 121–125. https://doi.org/10.1007/s11751-011-0116-1
  • Falkel, J.E., 1983. Amputation as a consequence of diabetes mellitus. An epidemiological review. Phys. Ther. 63, 960–964. https://doi.org/10.1093/ptj/63.6.960
  • Wallace, H.A., Perera, T.B., 2021. Necrotizing Fasciitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430756/
  • Hakkarainen, T.W., Kopari, N.M., Pham, T.N., Evans, H.L., 2014. Necrotizing soft tissue infections: review and current concepts in treatment, systems of care, and outcomes. Curr. Probl. Surg. 51, 344–362. https://doi.org/10.1067/j.cpsurg.2014.06.001
  • Hua, J., Friedlander, P., 2021. Cervical Necrotizing Fasciitis, Diagnosis and Treatment of a Rare Life-Threatening Infection. Ear. Nose. Throat J. 145561321991341. https://doi.org/10.1177/0145561321991341
  • Kaafarani, H.M.A., King, D.R., 2014. Necrotizing skin and soft tissue infections. Surg. Clin. North Am. 94, 155–163. https://doi.org/10.1016/j.suc.2013.10.011
  • Khamnuan, P., Chongruksut, W., Jearwattanakanok, K., Patumanond, J., Tantraworasin, A., 2015. Necrotizing fasciitis: epidemiology and clinical predictors for amputation. Int. J. Gen. Med. 8, 195–202. https://doi.org/10.2147/IJGM.S82999
  • Kwan, M.K., Saw, A., Chee, E.K., Lee, C.S., Lim, C.H., Zulkifle, N.A., et.al., 2006. Necrotizing fasciitis of the lower limb: an outcome study of surgical treatment. Med. J. Malaysia 61 Suppl A, 17–20.
  • Majeski, J., Majeski, E., 1997. Necrotizing fasciitis: improved survival with early recognition by tissue biopsy and aggressive surgical treatment. South. Med. J. 90, 1065–1068. https://doi.org/10.1097/00007611-199711000-00001
  • Misiakos, E.P., Bagias, G., Papadopoulos, I., Danias, N., Patapis, P., Machairas, N., et.al., 2017. Early Diagnosis and Surgical Treatment for Necrotizing Fasciitis: A Multicenter Study. Front. Surg. 4. https://doi.org/10.3389/fsurg.2017.00005
  • Muqim, R., 2003. Necrotizing fasciitis: management and outcome. J. Coll. Physicians Surg.--Pak. JCPSP 13, 711–714. https://doi.org/12.2003/JCPSP.711714
  • Myers, C.M., Miller, J.J., Davis, W.D., 2019. Skin and Soft Tissue Infections: A Case of Necrotizing Fasciitis. Adv. Emerg. Nurs. J. 41, 322–329. https://doi.org/10.1097/TME.0000000000000268
  • Ramakrishnan, K., Salinas, R.C., Agudelo Higuita, N.I., 2015. Skin and Soft Tissue Infections. Am. Fam. Physician 92, 474–483.
  • Rampal, S., Maniam, S., Lim, P.Y., Ramachandran, R., Tan, E.K., Halim, M.A.H.A., Shamsudin, Z., Singh, S.S.S., Narayanan, P., Neela, V.K., 2021. Necrotizing fasciitis, causative agents and management: a five-year retrospective study in two tertiary care hospitals in Central Malaysia. Int. Orthop. https://doi.org/10.1007/s00264-020-04905-2
  • Schmid, M.R., Kossmann, T., Duewell, S., 1998. Differentiation of necrotizing fasciitis and cellulitis using MR imaging. AJR Am. J. Roentgenol. 170, 615–620. https://doi.org/10.2214/ajr.170.3.9490940
  • Shaikh, N., 2006. Necrotizing fasciitis: A decade of surgical intensive care experience. Indian J. Crit. Care Med. 10, 225–229. https://doi.org/10.4103/0972-5229.29840
  • Singh, G., Bharpoda, P., Reddy, R., 2015. Necrotizing Fasciitis: A Study of 48 Cases. Indian J. Surg. 77, 345–350. https://doi.org/10.1007/s12262-013-0835-2
  • Voros, D., Pissiotis, C., Georgantas, D., Katsaragakis, S., Antoniou, S., Papadimitriou, J., 1993. Role of early and extensive surgery in the treatment of severe necrotizing soft tissue infection. Br. J. Surg. 80, 1190–1191. https://doi.org/10.1002/bjs.1800800943
  • Wong, C.H., Khin, L.W., Heng, K.S., Tan, K.C., Low, C.O., 2004. The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections. Crit. Care Med. 32, 1535–1541. https://doi.org/10.1097/01.ccm.0000129486.35458.7d
  • Wysoki, M.G., Santora, T.A., Shah, R.M., Friedman, A.C., 1997. Necrotizing fasciitis: CT characteristics. Radiology 203, 859–863. https://doi.org/10.1148/radiology.203.3.9169717
There are 21 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Clinical Research
Authors

Chandrakant R Kesarı 0000-0002-5638-132X

Raghunatha Reddy Hs This is me 0000-0001-5775-7862

Purushothaman R This is me 0000-0003-4587-8303

Preetham Raj This is me 0000-0003-1636-0716

Ganesh Bv This is me 0000-0002-0438-799X

Publication Date October 9, 2021
Submission Date April 16, 2021
Acceptance Date April 23, 2021
Published in Issue Year 2021 Volume: 38 Issue: 4

Cite

APA R Kesarı, C., Hs, R. R., R, P., Raj, P., et al. (2021). Laboratory Risk Indicator for Necrotising Fasciitis [LRINEC] Score as a Tool for Differentiating Necrotising Fasciitis from other Soft Tissue Infections. Journal of Experimental and Clinical Medicine, 38(4), 571-576.
AMA R Kesarı C, Hs RR, R P, Raj P, Bv G. Laboratory Risk Indicator for Necrotising Fasciitis [LRINEC] Score as a Tool for Differentiating Necrotising Fasciitis from other Soft Tissue Infections. J. Exp. Clin. Med. October 2021;38(4):571-576.
Chicago R Kesarı, Chandrakant, Raghunatha Reddy Hs, Purushothaman R, Preetham Raj, and Ganesh Bv. “Laboratory Risk Indicator for Necrotising Fasciitis [LRINEC] Score As a Tool for Differentiating Necrotising Fasciitis from Other Soft Tissue Infections”. Journal of Experimental and Clinical Medicine 38, no. 4 (October 2021): 571-76.
EndNote R Kesarı C, Hs RR, R P, Raj P, Bv G (October 1, 2021) Laboratory Risk Indicator for Necrotising Fasciitis [LRINEC] Score as a Tool for Differentiating Necrotising Fasciitis from other Soft Tissue Infections. Journal of Experimental and Clinical Medicine 38 4 571–576.
IEEE C. R Kesarı, R. R. Hs, P. R, P. Raj, and G. Bv, “Laboratory Risk Indicator for Necrotising Fasciitis [LRINEC] Score as a Tool for Differentiating Necrotising Fasciitis from other Soft Tissue Infections”, J. Exp. Clin. Med., vol. 38, no. 4, pp. 571–576, 2021.
ISNAD R Kesarı, Chandrakant et al. “Laboratory Risk Indicator for Necrotising Fasciitis [LRINEC] Score As a Tool for Differentiating Necrotising Fasciitis from Other Soft Tissue Infections”. Journal of Experimental and Clinical Medicine 38/4 (October 2021), 571-576.
JAMA R Kesarı C, Hs RR, R P, Raj P, Bv G. Laboratory Risk Indicator for Necrotising Fasciitis [LRINEC] Score as a Tool for Differentiating Necrotising Fasciitis from other Soft Tissue Infections. J. Exp. Clin. Med. 2021;38:571–576.
MLA R Kesarı, Chandrakant et al. “Laboratory Risk Indicator for Necrotising Fasciitis [LRINEC] Score As a Tool for Differentiating Necrotising Fasciitis from Other Soft Tissue Infections”. Journal of Experimental and Clinical Medicine, vol. 38, no. 4, 2021, pp. 571-6.
Vancouver R Kesarı C, Hs RR, R P, Raj P, Bv G. Laboratory Risk Indicator for Necrotising Fasciitis [LRINEC] Score as a Tool for Differentiating Necrotising Fasciitis from other Soft Tissue Infections. J. Exp. Clin. Med. 2021;38(4):571-6.