Comparative Study of Lrinec Score: Procalcitonin and Lrinec Score: C-Reactive Protein in Predicting Duration of Hospital Stay and Severity in Necrotising Fasciitis

Avalahalli, Manoj Gowda; Muniraja, Pavan Kumar; Khalid, Mohammed Suhail; Kaverappa, Kavitha; Devaraj, Lakshmi; Rao, A V Mohan

doi:10.14260/jemds/2016/754

Cited by 4 publications

(4 citation statements)

References 14 publications

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“…6 Recognizing NSTI can be challenging, because early symptoms of NSTI, such as swelling, erythema, pain are non-specific and can occur with many different types of infections. 7 Since delay in NSTI diagnosis contributes to increased mortality, an accurate and efficient diagnosis of NSTI is imperative for successfully treating patients with NSTI. 8 In 2004, a diagnostic scoring system called the Laboratory Risk Indicators for Necrotizing Fasciitis (LRINEC) score was created for this purpose.…”

Section: Introductionmentioning

confidence: 99%

Differentiating Lower Extremity Necrotizing Soft Tissue Infection from Severe Cellulitis by Laboratory Parameters and Relevant History Points

Wu¹,

Chang²

2021

IDR

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Background: Necrotizing soft tissue infection (NSTI) of the lower extremity (LE) is a rapidly progressing infection that requires early diagnosis and prompt treatment to decrease risks of loss of limb or life. Clinical presentation, particularly of early NSTI, can appear similar to severe cellulitis. The purpose of this study is to identify factors that are associated with NSTI rather than severe cellulitis to differentiate patients with similar clinical presentation. Methods: This retrospective cohort design study compares patients finally diagnosed with LE NSTI versus those diagnosed with severe cellulitis. Cohorts were matched using the modified Laboratory Risk Indicator for Necrotizing Fasciitis (m-LRINEC) score in the setting of LE soft tissue infection. Laboratory values, vital signs, subjective symptoms, and social factors including substance abuse were recorded. Univariate and multivariate analyses were performed. Results: Multivariate statistical analysis and clinical interpretation of data identified four factors more associated with a diagnosis of NSTI than severe cellulitis: elevated lactate, a patient-reported history of fever, male gender, and intravenous substance user. Conclusion:In patients with lower extremity infections, the clinical presentation of NSTI and severe cellulitis may appear similar. In this retrospective cohort of patients matched with m-LRINEC scores, elevated lactate, subjective fever, male gender, and intravenous substance abuser were significantly associated with NSTI rather than severe cellulitis. Further studies of these factors in the clinical setting can help tailor the differential diagnosis in the care of patients with severe lower extremity infections. Matched with m-LRINEC scores, elevated lactate, subjective fever, male gender, and intravenous substance abuser were significantly associated with NSTI rather than severe cellulitis. Further studies of these factors in the clinical setting can help tailor the differential diagnosis in the care of patients with severe lower extremity infections.

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Section: Introductionmentioning

confidence: 99%

Differentiating Lower Extremity Necrotizing Soft Tissue Infection from Severe Cellulitis by Laboratory Parameters and Relevant History Points

Wu¹,

Chang²

2021

IDR

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“…In contrast to this, upper limb was the most common site afflicted in a study done by Wall et al This can be attributed to the fact that most of the patients in that study were IV drug abusers (71%). 15,13 Most common risk factor in present study was smoking (80%). Compared to this, the most common risk factor in the study conducted by Wall et al was intravenous drug abuse (71%) while in the study by Yi -Chun Su et al, diabetes mellitus was the commonest predisposing factor.…”

Section: Discussionmentioning

confidence: 61%

Correlation of the laboratory risk indicators for necrotizing fasciitis (LRINEC) score with the clinical features and surgical management of necrotizing soft tissue infections

Kumar¹,

Garg²,

Soni³

et al. 2018

Int Surg J

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Background: Necrotizing fasciitis (NF) is a devastating soft tissue infection associated with potentially poor outcomes. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score has been introduced as a diagnostic tool for NF. We aimed to correlate the clinical features of NSTI with the LRINEC score, its application to distinguish Necrotizing Fasciitis (NF) from other non NSTI and its utility in early surgical management of NSTI.Methods: Patients were evaluated for various symptoms and signs at the time of admission and certain laboratory parameters were assessed. LRINEC score was then calculated. Correlation of the management and severity of infections with respective LRINEC score was then found out.Results: LRINEC score for predicting conservative management of NSTI has a sensitivity of 81.8% and specificity of 98% while for predicting amputation and mortality shows a sensitivity of 100% and specificity of 84.5%.Conclusions: The LRINEC score is a robust score capable of detecting even clinically early cases of necrotizing fasciitis.

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“…Efficiently managing NSTI begins with accurately diagnosing the condition. Identifying NSTI can pose challenges, as the initial symptoms, including swelling, redness, and pain, lack specificity and can be associated with various infection types [ 7 , 8 ]. Distinguishing an early diagnosis of NSTI from other soft tissue infections with a more favorable prognosis, such as limb cellulitis, can be a challenging task.…”

Section: Introductionmentioning

confidence: 99%

Role of Procalcitonin for Early Discrimination Between Necrotizing Fasciitis and Cellulitis of the Extremities

Vaibhavi,

P N,

Ullalkar

et al. 2024

Cureus

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Introduction Necrotizing fasciitis (NF) is a grave and life-threatening infection of the soft tissues. It is defined by the gradual necrosis of the fascia and subcutaneous tissue, which spreads along the fascial planes. Cellulitis, a prevalent skin infection, has led to suggestions that procalcitonin could serve as a diagnostic tool to distinguish it from other inflammatory skin conditions that resemble cellulitis. The study aims to assess the procalcitonin (PCT) levels in individuals with NF and cellulitis and determine its effectiveness in early differentiation between these two conditions. Methods After obtaining clearance from the institutional ethical committee, the study was conducted in the Department of General Surgery, Sri Devaraj Urs Medical College, over six months. Informed consent was obtained from all 30 patients included in this study. The study compared PCT levels in patients diagnosed with NF and cellulitis. Statistical analysis was performed using SPSS version 22 software (IBM Corp., Armonk, NY, USA). Results The mean age of subjects was 53.23 ± 8.78 years. Among patients, 21 (70%) were diagnosed with cellulitis and 9 (30%) were diagnosed with NF. The mean PCT levels were 0.34 ± 0.32 and 4.89 ± 1.98 among the cellulitis and NF groups, respectively. There was a significant difference (p<0.05). PCT had a sensitivity of 100% and a specificity of 100%, in differentiating cellulitis and necrotizing fasciitis. Conclusion PCT levels were notably elevated in cases of NF compared to cellulitis. Despite the study's limited sample size, it represents the first report highlighting the value of PCT as an early diagnostic tool for identifying necrotizing fasciitis.

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Comparative Study of Lrinec Score: Procalcitonin and Lrinec Score: C-Reactive Protein in Predicting Duration of Hospital Stay and Severity in Necrotising Fasciitis

Cited by 4 publications

References 14 publications

Differentiating Lower Extremity Necrotizing Soft Tissue Infection from Severe Cellulitis by Laboratory Parameters and Relevant History Points

Differentiating Lower Extremity Necrotizing Soft Tissue Infection from Severe Cellulitis by Laboratory Parameters and Relevant History Points

Correlation of the laboratory risk indicators for necrotizing fasciitis (LRINEC) score with the clinical features and surgical management of necrotizing soft tissue infections

Role of Procalcitonin for Early Discrimination Between Necrotizing Fasciitis and Cellulitis of the Extremities

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