Journal of Emergencies, Trauma, and Shock
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Year : 2021  |  Volume : 14  |  Issue : 1  |  Page : 38-41

Laboratory risk indicator for necrotizing fasciitis score and patient outcomes

1 Emergency and Critical Care Center, Kurashiki Central Hospital, Kurashiki City; Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
2 Emergency and Critical Care Center, Kurashiki Central Hospital, Kurashiki City, Japan

Correspondence Address:
Dr. Jun Fujinaga
Emergency and Critical Care Center, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki City, Okayama 710-8602
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JETS.JETS_17_20

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Context: The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score helps to diagnose necrotizing soft-tissue infection (NSTI). The LRINEC score has been reported to be associated with poor prognosis, although few studies have evaluated this association. Aims: We aimed to describe the characteristics of NSTI and assess whether the LRINEC score was associated with mortality and amputation. Settings and Design: We conducted a retrospective observational study from January 2007 to May 2018, in a Japanese tertiary care hospital. Subjects and Methods: Patients with NSTI were identified through our hospital database using the discharge diagnosis. We extracted data on patient characteristics, laboratory examinations, microbiological information, treatment, and in-hospital mortality. Statistical Analysis Used: We estimated the odds ratios (ORs) and associated 95% confidence intervals (CIs) for in-hospital mortality using logistic regression models. Results: We identified 58 patients. The median LRINEC score was 8 (interquartile range [IQR]: 6–9). Forty-four patients (75.9%) scored 6 or more. The eight patients with amputations had a median score of 6 (IQR: 4.5–7.5) versus 8 (IQR: 7–9) for patients who underwent debridement (P = 0.091). Survivors and nonsurvivors had median scores of 8 (IQR: 6–9) and 6 (IQR: 5–8), respectively (P = 0.148). The OR for mortality in patients with liver cirrhosis was 10.5 (95% CI: 1.00–110.36; P = 0.050). Conclusions: There was no association between the LRINEC score and patients' outcomes: mortality and amputation. Further studies are warranted to evaluate the utility of the LRINEC score and factors associated with poor prognosis in patients with NSTI.

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