Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Department of Otolaryngology-Head and Neck Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
ANZ J Surg. 2022 Jul;92(7-8):1631-1637. doi: 10.1111/ans.17459. Epub 2022 Jan 10.
Recent studies have attempted to verify the predictive capability of the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) for cervical necrotizing fasciitis (CNF).
The two authors independently reviewed six databases (PubMed, Cochrane, Embase, Web of Science, SCOPUS and Google Scholar databases were searched). Seven cohort studies were included in the analysis. Sensitivity and specificity were determined by extracting items from binary classification from each paper. The diagnostic accuracy of the included studies was evaluated using QUADAS ver. 2.
The diagnostic odds ratio (OR) of LRINEC for CNF with the cutoff value of 6 was 13.9952 (95% CI, 3.8537; 50.8255, I = 76.7%). The area under the SROC curve was 0.842, suggesting acceptable diagnostic accuracy. The correlation between sensitivity and false positive rate was 0.055, indicating that it was not heterogeneous. The sensitivity, specificity, and negative predictive values were 0.7503 ([0.4637; 0.9126], I = 79.1%), 0.8455 ([0.7084; 0.9250], I = 96.0%) and 0.9829 ([0.9089; 0.9970], I = 93.7%), respectively. In the comparison of subgroups according to a LRINEC score (6-8, and), the cutoff value of 6 showed moderate sensitivity (75%) and high specificity (85%) and greater diagnostic power than other cutoff values.
LRINEC is a useful adjunctive tool for predicting CNF in patients with a soft tissue infection. In addition, a more accurate diagnosis is possible by using the LRINEC score with a cutoff value of 6.
最近的研究试图验证实验室风险指标对坏死性筋膜炎（LRINEC）对颈坏死性筋膜炎（CNF）的预测能力。
两位作者独立查阅了六个数据库（PubMed、Cochrane、Embase、Web of Science、SCOPUS 和 Google Scholar 数据库进行了搜索）。共有 7 项队列研究纳入分析。从每篇论文的二分类中提取项目来确定灵敏度和特异性。使用 QUADAS ver.2 评估纳入研究的诊断准确性。
LRINEC 用于 CNF 的截断值为 6 的诊断优势比（OR）为 13.9952（95%置信区间，3.8537；50.8255，I = 76.7%）。SROC 曲线下面积为 0.842，表明具有可接受的诊断准确性。灵敏度和假阳性率之间的相关性为 0.055，表明没有异质性。灵敏度、特异性和阴性预测值分别为 0.7503（[0.4637；0.9126]，I = 79.1%）、0.8455（[0.7084；0.9250]，I = 96.0%）和 0.9829（[0.9089；0.9970]，I = 93.7%）。根据 LRINEC 评分（6-8 分和）进行亚组比较时，截断值为 6 时具有中等灵敏度（75%）和高特异性（85%），比其他截断值具有更大的诊断能力。
LRINEC 是预测软组织感染患者 CNF 的有用辅助工具。此外，使用截断值为 6 的 LRINEC 评分可以进行更准确的诊断。
