Series of 41 cases of necrotizing fasciitis in a tertiary level hospital. Is as deadly as we think? LRINEC scale is useful today?

Abstract

Introduction: necrotizing fasciitis (NF) is a rare soft tissue infection that leads to sepsis and death without an early surgical treatment. LRINEC (laboratory risk indicator for necrotizing fasciitis) scale is one of the most accepted tests for diagnosis. This study presents a retrospective evaluation of the usefulness of the LRINEC scale in the diagnosis and prognosis of NF.

Material and methods: retrospective study of 41 cases of NF in extremities between 2010 and 2019. Based on the score obtained on the LRINEC scale the cases were assigned to: LRINEC lower than 5 in Group 1 with 12 cases, score 6 or 7 in Group 2 also 12 cases, and finally score of 8 or above in Group 3, 17 cases.

Results: the mean LRINEC score was 7.04 (range: 1-13). 30 patients (73%) had scores above 6, the threshold for suspicion of NF. The mean mortality rate was 26.8%, and was highest in group 3 (5 deaths). The mean amputation rate was 17% (seven patients).

Conclusions: the LRINEC may facilitate early diagnosis, but as we see in our study its main strength is its ability to assess the severity of the septic process and therefore to provide a prognosis.