A Study on LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) as a Tool for Early Diagnosis & Management of Necrotizing Fasciitis

Aims and Objectives: 1. To apply the LRINEC score as a tool for early diagnosis of necrotizing fascitis among patients presenting with soft tissue infection. 2. For early surgical intervention and better outcome in patient presenting with necrotizing fascitis. Methods: The present study was carried out in the Department of General Surgery, Kamineni Institute of Medical Sciences, Narketpally. The study includes 50 patients who were admitted during the period from October 2020-September 2021. Results: LRINEC score 8 high risk. Incidence was highest in the age group ranging from 51- 60 years. M:F = 2.3:1. More common in lower limbs (66.4%) and scrotum (33.6%). All the patients presented with swelling, redness, pain and induration. Diabetis Mellitus was detected as a co-morbidity (52%). The score was able to identify the necessity of surgical management for 23(46%) of patients. ? Conservative treatment was proposed to 48% of cases, 32% needed debridement, 16% needed fasciotomy and 4% underwent amputation. The culture & sensitivity showed more of poly-microbial organisms (52%) than mono microbial (32%) and skin commensals (16%). The mortality is seen in 3 cases (6%), due to multiple co-morbidities and the LRINEC score was >8. Conclusion: Necrotizing fascitis is a rare and life threatening condition that requires immediate action, but uncertainties still hampers prompt diagnosis and treatment. LRINEC scoring system has a better positively predictive value in identifying the onset of necrotizing fasciitis and risk strategizing of the patients with severe soft tissue infection. At the end of my study the LRINEC scoring has been validated and found to have an accurate diagnostic tool in predicting the outcome of patients with soft tissue infections.