Syed A, Alvin T, Fazrina A, Abdul R
Department of Orthopaedics, Hospital Tuanku Ja'afar Seremban, Seremban, Malaysia.
Malays Orthop J. 2017 Jul;11(2):36-39. doi: 10.5704/MOJ.1707.005.
Necrotising fasciitis (NF) is a rapidly progressive infection of the subcutaneous tissue and fascia which spreads rapidly. The scoring system of Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) developed by Wong has been proposed as a tool for distinguishing NF and other soft tissue infections (STI) in Singapore. We set out to establish whether the LRINEC score is applicable in our Malaysian setting. A cross sectional study of all patients admitted to our hospital diagnosed with NF or To Rule Out NF (TRO NF) between January 1st 2016 to 30th June 2016. The sensitivity, specificity, positive and negative predictive values were then calculated for LRINEC score of ≥ 6 and ≥ 8. Fourty-four patients were identified with the diagnosis of NF or TRO NF in the study. Twenty-seven patients (61.4%) were deemed post-operatively as having NF and 17 patients (38.6%) not having NF. A sensitivity of 59.3% and specificity of 47.1% when a LRINEC score of ≥ 6 was taken with positive predictive value (PPV) of 64.0% and the negative predictive value (NPV) of 42.1%. When score ≥ 8 was taken, the sensitivity was 48.1% and specificity of 58.8% with PPV of 65% and NPV of 41.7%. The low sensitivity and low PPV achieved in this study as well as other studies makes the LRINEC score unsuitable to be used solely to distinguish NF with other soft tissue infections.
坏死性筋膜炎（NF）是一种皮下组织和筋膜的快速进展性感染，传播迅速。Wong开发的坏死性筋膜炎实验室风险指标（LRINEC）评分系统已被提议作为新加坡区分NF和其他软组织感染（STI）的工具。我们着手确定LRINEC评分在我们马来西亚的环境中是否适用。对2016年1月1日至2016年6月30日期间我院收治的所有诊断为NF或排除NF（TRO NF）的患者进行了横断面研究。然后计算LRINEC评分≥6和≥8时的敏感性、特异性、阳性和阴性预测值。在该研究中，确定了44例诊断为NF或TRO NF的患者。27例患者（61.4%）术后被认为患有NF，17例患者（38.6%）未患有NF。当LRINEC评分≥6时，敏感性为59.3%，特异性为47.1%，阳性预测值（PPV）为64.0%，阴性预测值（NPV）为42.1%。当评分≥8时，敏感性为48.1%，特异性为58.8%，PPV为65%，NPV为41.7%。本研究以及其他研究中获得的低敏感性和低PPV使得LRINEC评分不适用于仅用于区分NF与其他软组织感染。
