A study on role of laboratory risk indicator for necrotizing fasciitis score in necrotizing fasciitis

Abstract

Background: Necrotizing fasciitis (NF) represents a group of highly lethal infection characterized by rapidly progressing inflammation and necrosis. The spectrum of disease ranges from necrosis of the skin to life threatening infection. Laboratory risk indicator for necrotizing fasciitis (LRINEC) score is only scoring system available so far to help us towards making an early and accurate diagnosis.Methods: The current prospective observational study was conducted in the Surgery OPD and emergency, Department of surgery, Dr. B.R. Ambedkar Memorial Hospital, Raipur, CG, India, during study period October 2017 to September 2018. Sample size was fixed at 100. Blood tests taken on admission were used to calculate the LRINEC score in each case.Results: In this study 55% of patients with soft tissue infections were categorized as low risk for progression of NF. Necrotizing soft tissue infection (NSTI) occurs in all age groups, ranging from 18 to 75 years. Clinical findings of crepitus were found in 33% of all patients of NSTI. 96% of the patients underwent debridement once, debridement was done twice in 3% of the patients while debridement was not done in 1% of the patients who belonged to high risk group and had no comorbidities. Out of 100, 3 patients underwent amputation. We found that there is mortality rate of 5%.Conclusions: NF was most severe form of soft tissue infection, potentially life and limb threatening. Early diagnosis of NF is essential for early management and better prognosis of patients.