EBQ:LRINEC Score: Difference between revisions
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==Major Points== | ==Major Points== | ||
Using six laboratory measurements a Score greater than or equal to 6 indicates that necrotizing fasciitis should be considered high on the differential diagnosis. The LRINEC Scoring system is: | Using six laboratory measurements a Score greater than or equal to 6 indicates that necrotizing fasciitis should be considered high on the differential diagnosis. The LRINEC Scoring system is: | ||
*CRP (mg/L) ≥150: 4 points | *CRP (mg/L) ≥150: '''4 points''' | ||
*WBC count (×10<sup>3</sup>/mm<sup>3</sup>) | *WBC count (×10<sup>3</sup>/mm<sup>3</sup>) | ||
**<15: 0 points | **<15: '''0 points''' | ||
**15–25: 1 point | **15–25: '''1 point''' | ||
**>25: 2 points | **>25: '''2 points''' | ||
*Hemoglobin (g/dL) | *Hemoglobin (g/dL) | ||
**>13.5: 0 points | **>13.5: '''0 points''' | ||
**11–13.5: 1 point | **11–13.5: '''1 point''' | ||
**<11: 2 points | **<11: '''2 points''' | ||
*Sodium (mmol/L) <135: 2 points | *Sodium (mmol/L) <135: '''2 points''' | ||
*Creatinine (umol/L) >141: 2 points | *Creatinine (umol/L) >141: '''2 points''' | ||
*Glucose (mmol/L) >10: 1 | *Glucose (mmol/L) >10: '''1 point''' | ||
==Study Design== | ==Study Design== | ||
Revision as of 15:15, 29 December 2014
Under Review Journal Club Article
Wong C. "The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections". Crit Care Med. 2004. 32(7):1535-41.
PubMed Full text PDF
PubMed Full text PDF
Clinical Question
- Is it possible to develop a diagnostic scoring system to distinguish necrotizing fasciitis (NF) from other soft tissue infections based on laboratory tests routinely performed for the evaluation of severe soft tissue infections?
- Developed the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score to aid in the to risk stratification of patients presenting with signs of cellulitis in order determine likelihoood of NF.
Conclusion
- The LRINEC score may help in detecting cases of necrotizing fasciitis, even early in the disease course. The variables used in the score are routinely measured to assess severe soft tissue infections. Patients with LRINEC score ≥ 6 should be careful evaluated for the presence of necrotizing fasciitis.
Major Points
Using six laboratory measurements a Score greater than or equal to 6 indicates that necrotizing fasciitis should be considered high on the differential diagnosis. The LRINEC Scoring system is:
- CRP (mg/L) ≥150: 4 points
- WBC count (×103/mm3)
- <15: 0 points
- 15–25: 1 point
- >25: 2 points
- Hemoglobin (g/dL)
- >13.5: 0 points
- 11–13.5: 1 point
- <11: 2 points
- Sodium (mmol/L) <135: 2 points
- Creatinine (umol/L) >141: 2 points
- Glucose (mmol/L) >10: 1 point
Study Design
- Retrospective observational study, two teaching tertiary care hospitals
- Patients divided into a developmental cohort (N=314) and a validation cohort (N=140)
Population
Patient Demographics
Inclusion Criteria
Exclusion Criteria
Interventions
Outcomes
Primary Outcome
Secondary Outcomes
Subgroup analysis
Criticisms & Further Discussion
Funding
Sources
[{Category:Derm]]