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World Journal of Emergency Surgery

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Open Access 01-12-2021 | Necrotizing Fasciitis | Research article

Utility of modified Laboratory Risk Indicator for Necrotizing Fasciitis (MLRINEC) score in distinguishing necrotizing from non-necrotizing soft tissue infections

Authors: Po-Han Wu, Kai-Hsiang Wu, Cheng-Ting Hsiao, Shu-Ruei Wu, Chia-Peng Chang

Published in: World Journal of Emergency Surgery | Issue 1/2021

Abstract

Background

We conducted this study to promote a modified Laboratory Risk Indicator for Necrotizing Fasciitis (MLRINEC) score and evaluate the utility in distinguishing necrotizing fasciitis (NF) from other soft-tissue infections.

Method

A retrospective cohort study of hospitalized patients with NF diagnosed by surgical finding was conducted in two tertiary hospital in southern Taiwan between January 2015 and January 2020. Another group was matched by controls with non-necrotizing soft tissue infections based on time, demographics, and immune status. Data such as infectious location, comorbidities, and laboratory findings were recorded and compared. Logistics regression were used to determine the association with NF after adjustment for confounders and MLRINEC score was developed by then. Receiver operating curve (ROC) and the area under the curve (AUC) were used to evaluate its discriminating ability.

Result

A total of 303 patients were included; 101 in NF group and 202 in non-NF group. We added serum lactate and comorbid liver disease to the original LRINEC score and re-defined the cut-off values for 3 variables to develop the MLRINEC score. The cut-off value for MLRINEC score was 12 points with corresponding sensitivity of 91.8% and a specificity of 88.4%, and the area under ROC (AUC) was 0.893 (95% CI, 0.723 to 0.948; p < 0.01).

Conclusion

MLRINEC score shows a high sensitivity and specificity in distinguishing NF from non-necrotizing soft-tissue infections. Patients with a MLRINEC score > 12 points should be highly suspected of presence of necrotizing fasciitis.

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Title: Utility of modified Laboratory Risk Indicator for Necrotizing Fasciitis (MLRINEC) score in distinguishing necrotizing from non-necrotizing soft tissue infections
Authors: Po-Han Wu
Kai-Hsiang Wu
Cheng-Ting Hsiao
Shu-Ruei Wu
Chia-Peng Chang
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Necrotizing Fasciitis
Soft Tissue Infection
Published in: World Journal of Emergency Surgery / Issue 1/2021
Electronic ISSN: 1749-7922
DOI: https://doi.org/10.1186/s13017-021-00373-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Utility of modified Laboratory Risk Indicator for Necrotizing Fasciitis (MLRINEC) score in distinguishing necrotizing from non-necrotizing soft tissue infections

Abstract

Background

Method

Result

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Method

Result

Conclusion

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