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(/* Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score Wong C. "The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections". Crit Care Med. 20...)
 
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*May use to risk stratify patients with signs of cellulitis but concern for deep space infection. It is useful in context of a diagnosed or strongly suspected severe soft-tissue infection
===[[EBQ:LRINEC Score|Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score]]<ref> Wong C. "The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections". Crit Care Med. 2004. 32(7):1535-41.</ref>===
*Score based on: '''CRP, WBC, Hb, Na, Cr, Glucose''' and a Score > 6 has '''PPV of 92%''' and '''NPV of 96%''' for necrotizing fasciitis
''Has not been prospectively validated, index of suspicion is key and 10% of the patients with a score < 6 had Necrotizing Fasciitis. A score > 6 has '''PPV of 92%''' and '''NPV of 96%''' for necrotizing fasciitis.''


''Be aware LRINEC score has not been prospectively validated, index of suspicion is key and 10% of the patients with a score < 6 had Necrotizing Fasciitis''<ref> Wong C. "The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections". Crit Care Med. 2004. 32(7):1535-41.</ref>
#CRP (mg/L) ≥150: '''4 points'''
#WBC count (×10<sup>3</sup>/mm<sup>3</sup>)
#*<15: '''0 points'''
#*15–25: '''1 point'''
#*>25: '''2 points'''
#Hemoglobin (g/dL)
#*>13.5: '''0 points'''
#*11–13.5: '''1 point'''
#*<11: '''2 points'''
#Sodium (mmol/L) <135: '''2 points'''
#Creatinine (umol/L) >141: '''2 points'''
#Glucose >180 mg/dL (10 mmol/L): '''1 point'''


*CRP (mg/L) ≥150: '''4 points'''
===Grouping by Scores===
*WBC count (×10<sup>3</sup>/mm<sup>3</sup>)
*Low Risk: score 5 (10% of pts with score < 6 still had nec fasc)
**<15: '''0 points'''
*Moderate Risk: score 6– 7
**15–25: '''1 point'''
*High Risk: score >8
**>25: '''2 points'''
*Hemoglobin (g/dL)
**>13.5: '''0 points'''
**11–13.5: '''1 point'''
**<11: '''2 points'''
*Sodium (mmol/L) <135: '''2 points'''
*Creatinine (umol/L) >141: '''2 points'''
*Glucose (mmol/L) >10: '''1 point'''


'''Grouping by Scores:'''
[http://www.hneed.com/storage/LRINEC%20algorithm.jpg Proposed algorithm]
*Low Risk: score 5
*Moderate Risk: score 6– 7
*High Risk: score �8

Latest revision as of 21:19, 28 June 2016

Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score[1]

Has not been prospectively validated, index of suspicion is key and 10% of the patients with a score < 6 had Necrotizing Fasciitis. A score > 6 has PPV of 92% and NPV of 96% for necrotizing fasciitis.

  1. CRP (mg/L) ≥150: 4 points
  2. WBC count (×103/mm3)
    • <15: 0 points
    • 15–25: 1 point
    • >25: 2 points
  3. Hemoglobin (g/dL)
    • >13.5: 0 points
    • 11–13.5: 1 point
    • <11: 2 points
  4. Sodium (mmol/L) <135: 2 points
  5. Creatinine (umol/L) >141: 2 points
  6. Glucose >180 mg/dL (10 mmol/L): 1 point

Grouping by Scores

  • Low Risk: score 5 (10% of pts with score < 6 still had nec fasc)
  • Moderate Risk: score 6– 7
  • High Risk: score >8

Proposed algorithm

  1. ↑ Wong C. "The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections". Crit Care Med. 2004. 32(7):1535-41.
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