Distribution of Necrotizing fasciitis Using the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score Among Patients Attending a Tertiary Hospital in Chennai

Cureus. 2024 Nov 15;16(11):e73755. doi: 10.7759/cureus.73755. eCollection 2024 Nov.

Abstract

Background Necrotizing fasciitis (NF) is a rapidly progressing infection with a high mortality rate, requiring prompt diagnosis and treatment. The Laboratory Risk Indicator for NF (LRINEC) score has emerged as a useful tool for early risk stratification. Methods A cross-sectional study was conducted on 112 patients diagnosed with NF in a tertiary hospital in Chennai. Clinical data, including LRINEC scores and associated laboratory parameters, were collected and analyzed. The relationship between LRINEC scores and risk factors, such as gender, comorbidities (diabetes mellitus [DM] and peripheral vascular disease [PVD]), recent trauma, C-reactive protein (CRP) levels, white blood cell count (WBC) counts, and creatinine levels, was assessed. The treatment approaches and complications were also reviewed. Results The LRINEC score effectively stratified patients: 51.8% were at low risk, 33.9% at moderate risk, and 14.3% at high risk. Significant associations were found between higher LRINEC scores and elevated CRP, WBC count, creatinine levels, and low sodium levels (p < 0.001). DM and PVD were important comorbidities influencing disease severity. Conservative treatments, including hygroscopic dressings and antibiotics, were successful in 83.9% of cases, while 16.1% required surgical debridement. Complications included delayed wound healing (14.3%) and skin grafting (1.8%). Conclusion The LRINEC score is an effective tool for the early diagnosis and stratification of NF. Its use in clinical practice helps guide decision-making, particularly regarding early interventions and improving patient outcomes.

Keywords: diabetes mellitus type 2; elevated c-reactive protein (crp); group a strep sepsis; lrinec score; necrotising fasciitis (nf).