A Clinical Study to Evaluate Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score-as a Tool for Differentiating Necrotizing Fasciitis of the Extremities from Severe Cellulitis in a Tertiary Care Hospital: Tezpur Medical College and Hosp

Background: Necrotizing fasciitis (NF) and severe cellulitis are severe soft tissue infections that require prompt differentiation for timely management. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score has been proposed as a diagnostic tool to aid in this differentiation. Methods: A retrospective cohort study was conducted at Tezpur Medical College and Hospital, involving 500 adult patients with suspected severe soft tissue infections of the extremities. The LRINEC score was calculated for each patient based on six laboratory parameters: C-reactive protein (CRP), white blood cell count (WBC), hemoglobin, sodium, creatinine, and glucose. Diagnostic accuracy measures, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), were assessed to evaluate the utility of the LRINEC score in distinguishing necrotizing fasciitis from severe cellulitis. Results: A total of 500 patients were included in the study, with a mean age of 55 years (range 20-85 years). The study population consisted of 60% males and 40% females. Comorbidities such as diabetes mellitus (35%), hypertension (28%), and obesity (20%) were prevalent among the patients. Conclusion: The LRINEC score serves as a valuable adjunctive tool in the early identification and differentiation of necrotizing fasciitis from severe cellulitis. It aids clinicians in making timely management decisions, potentially improving patient outcomes and resource utilization.