2nd Otolaryngology Department, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Rimini 1, Chaidari, 124 62, Athens, Greece.
Department of Informatics, University of Piraeus, Piraeus, Greece.
Eur Arch Otorhinolaryngol. 2021 Nov;278(11):4587-4592. doi: 10.1007/s00405-021-06653-4. Epub 2021 Feb 9.
The aim of this retrospective review study is to evaluate Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score as an indicative parameter in early detecting cervical necrotizing fasciitis (CNF) from deep neck infections (DNI).
We reviewed 12 cases of CNF and 538 cases of non-necrotizing deep neck infection hospitalized in our hospital over the last decade. Cervical necrotizing fasciitis was histologically confirmed.
Using an LRINEC score of 6 as a cutoff sensitivity was calculated at 100% (95% CI 99.9-100) and specificity 72.5% (95% CI 72.4-72.6). Negative predicted value (NPV) was 100% and positive predicted value (PPV) was 7.5%. C-reactive protein (CRP), white blood count (WBC), and glucose (Glu) levels have a higher correlation. Haemoglobin (Hb), sodium (Na), and creatinine (Cr) do not seem to have a big impact in our study.
LRINEC score proves to be a useful "rule-out" tool that works on the safe side with high sensitivity and poor specificity. WBC, CRP, and Glu seem to be the most significant variables of the LRINEC score. Hb, Na, and Cr make the score safer. Decision for surgery must be based on medical history, clinical symptoms and signs, imaging findings, and laboratory tests and not according to the LRINEC score itself.
本回顾性研究旨在评估实验室危险指数用于坏死性筋膜炎（LRINEC）评分作为早期检测颈部坏死性筋膜炎（CNF）的指标，该评分来自深部颈部感染（DNI）。
我们回顾了过去十年我院收治的 12 例 CNF 和 538 例非坏死性深部颈部感染患者。通过组织学证实了颈部坏死性筋膜炎。
使用 6 分的 LRINEC 评分作为截断值，灵敏度为 100%（95%CI 99.9-100），特异性为 72.5%（95%CI 72.4-72.6）。阴性预测值（NPV）为 100%，阳性预测值（PPV）为 7.5%。C 反应蛋白（CRP）、白细胞计数（WBC）和血糖（Glu）水平相关性更高。血红蛋白（Hb）、钠（Na）和肌酐（Cr）在我们的研究中似乎没有很大影响。
LRINEC 评分被证明是一种有用的“排除”工具，具有较高的灵敏度和较差的特异性，较为安全。WBC、CRP 和 Glu 似乎是 LRINEC 评分中最重要的变量。Hb、Na 和 Cr 使评分更安全。手术决策必须基于病史、临床症状和体征、影像学发现以及实验室检查，而不是根据 LRINEC 评分本身。
