Laboratory Risk Indicator for Necrotizing Fasciitis Score and Patient Outcomes.

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 ( = 0.091). Survivors and nonsurvivors had median scores of 8 (IQR: 6-9) and 6 (IQR: 5-8), respectively ( = 0.148). The OR for mortality in patients with liver cirrhosis was 10.5 (95% CI: 1.00-110.36; = 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.