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Assesment of a Novel Scoring System in Treating Necrotising Fasciitis

Chethan Kishanchand, Associate Professor, Department of General Surgery, Kasturba Medical College, Manipal, Karnataka 576104, India , Balaji Jayasankara , Chethan Kishanchandb , Raunak Maruc

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New Indian Journal of Surgery 9(2):p 127-132, March - April 2018. | DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9218.3

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Abstract

Background: Early operative debridement is a major determinant of outcome in necrotizing fasciitis which could often prove clinically difficult. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score was devised as a scoring system for necrotising fasciitis. Our study was done for the validation of the same.

Methods: The study was a prospective observational and descriptive study in a tertiary care teaching hospital. This was mainly done to assess the LRINEC scoring system and validate the system Patients presenting with soft tissue infections admitted over a period of two years were clinically examined and subjected to a proforma of the LRINEC scoring system. The same was assessed statistically to interpret the outcomes with regards to the scoring.

Results: A total of 152 patients with suspected necrotising fasciitis were taken for the study out of which 96 patients underwent surgical debridement. On calculating the strength of association of individual variable with the scoring system LRINEC - Age/Hb/TLC/RBS/S. Creatinine/CRP has been found to be independently significant variables. Receiver operating characteristic (ROC) curves showed a positive predictive value of 94.7%.

Conclusions: LRINEC scoring system is helpful in stratifying patients into risk categories, thus appears capable of detecting early cases of necrotizing fasciitis and is simple enough for routine use.

 

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DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9218.3

Keywords

Debridement; LRINEC Scoring System; Necrotising Fasciitis.

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