What is the accuracy of the laboratory risk indicator for necrotizing fasciitis (LRINEC)?

Updated: Oct 17, 2018
  • Author: Steven A Schulz, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

A study by Sandner et al indicated that the laboratory risk indicator for necrotizing fasciitis (LRINEC) is an effective tool for early detection of cervical necrotizing fasciitis. The investigators, who used a cutoff score of 6, reported that the LRINEC had a sensitivity and specificity for cervical necrotizing fasciitis of 94%, as well as a positive predictive value of 29% and a negative predictive value of 99%. The study included 16 patients with the disease and 595 patients with severe nonnecrotizing neck infections. [57]  A retrospective study by Narasimhan et al reported that an LRINEC score of 5 or above had a sensitivity of 76.3% and a specificity of 93.1% in the diagnosis of necrotizing fasciitis, with positive and negative predictive values being 95.5% and 88.1%, respectively. [58]

In contrast, however, a literature review by Fernando et al indicated that an LRINEC score of 6 or above has a sensitivity and specificity of 68.2% and 84.8%, respectively, in the detection of necrotizing soft tissue infection, while a score of 8 or above has a sensitivity and specificity of 40.8% and 94.9%, respectively. [59]


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