Laboratory risk indicator for necrotizing fasciitis score and patient outcomes

• Published in: Journal of emergencies, trauma and shock Vol. 14; no. 1; pp. 38 - 41
• Main Authors: Fujinaga, Jun, Kuriyama, Akira, Ikegami, Tetsunori, Onodera, Mutsuo
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01-01-2021; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Amputation; analysis; Emergency medical care; Infection; Laboratories; laboratory risk indicator for necrotizing fasciitis score; Liver cirrhosis; Mortality; Necrotizing fasciitis; necrotizing soft-tissue infections; Original; Patient outcomes; Patients; Prognosis; Japan; Analysis; Laboratory Risk Indicator for Necrotizing Fasciitis score; necrotizing soft-tissue infections
• ISSN: 0974-2700; 0974-519X
• DOI: 10.4103/JETS.JETS_17_20

Context: The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score helps to diagnose necrotizing soft-tissue infection (NSTI). The LRINEC score has been reported to be associated with poor prognosis, although few studies have evaluated this association. Aims: We aimed to describe the characteristics of NSTI and assess whether the LRINEC score was associated with mortality and amputation. Settings and Design: We conducted a retrospective observational study from January 2007 to May 2018, in a Japanese tertiary care hospital. Subjects and Methods: Patients with NSTI were identified through our hospital database using the discharge diagnosis. We extracted data on patient characteristics, laboratory examinations, microbiological information, treatment, and in-hospital mortality. Statistical Analysis Used: We estimated the odds ratios (ORs) and associated 95% confidence intervals (CIs) for in-hospital mortality using logistic regression models. Results: We identified 58 patients. The median LRINEC score was 8 (interquartile range [IQR]: 6-9). Forty-four patients (75.9%) scored 6 or more. The eight patients with amputations had a median score of 6 (IQR: 4.5-7.5) versus 8 (IQR: 7-9) for patients who underwent debridement (P = 0.091). Survivors and nonsurvivors had median scores of 8 (IQR: 6-9) and 6 (IQR: 5-8), respectively (P = 0.148). The OR for mortality in patients with liver cirrhosis was 10.5 (95% CI: 1.00-110.36; P = 0.050). Conclusions: There was no association between the LRINEC score and patients' outcomes: mortality and amputation. Further studies are warranted to evaluate the utility of the LRINEC score and factors associated with poor prognosis in patients with NSTI.