Utility of modified Laboratory Risk Indicator for Necrotizing Fasciitis (MLRINEC) score in distinguishing necrotizing from non-necrotizing soft tissue infections
Abstract Background We conducted this study to promote a modified Laboratory Risk Indicator for Necrotizing Fasciitis (MLRINEC) score and evaluate the utility in distinguishing necrotizing fasciitis (NF) from other soft-tissue infections. Method A retrospective cohort study of hospitalized patients...
Main Authors: | , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2021-05-01
|
Series: | World Journal of Emergency Surgery |
Subjects: | |
Online Access: | https://doi.org/10.1186/s13017-021-00373-0 |
id |
doaj-a34b2ef571c34623b00265eb2c1fb867 |
---|---|
record_format |
Article |
spelling |
doaj-a34b2ef571c34623b00265eb2c1fb8672021-05-30T11:31:21ZengBMCWorld Journal of Emergency Surgery1749-79222021-05-011611610.1186/s13017-021-00373-0Utility of modified Laboratory Risk Indicator for Necrotizing Fasciitis (MLRINEC) score in distinguishing necrotizing from non-necrotizing soft tissue infectionsPo-Han Wu0Kai-Hsiang Wu1Cheng-Ting Hsiao2Shu-Ruei Wu3Chia-Peng Chang4Department of Emergency Medicine, Chang Gung Memorial HospitalDepartment of Emergency Medicine, Chang Gung Memorial HospitalDepartment of Emergency Medicine, Chang Gung Memorial HospitalDepartment of Pediatrics, Kaohsiung Veterans General HospitalDepartment of Emergency Medicine, Chang Gung Memorial HospitalAbstract Background We conducted this study to promote a modified Laboratory Risk Indicator for Necrotizing Fasciitis (MLRINEC) score and evaluate the utility in distinguishing necrotizing fasciitis (NF) from other soft-tissue infections. Method A retrospective cohort study of hospitalized patients with NF diagnosed by surgical finding was conducted in two tertiary hospital in southern Taiwan between January 2015 and January 2020. Another group was matched by controls with non-necrotizing soft tissue infections based on time, demographics, and immune status. Data such as infectious location, comorbidities, and laboratory findings were recorded and compared. Logistics regression were used to determine the association with NF after adjustment for confounders and MLRINEC score was developed by then. Receiver operating curve (ROC) and the area under the curve (AUC) were used to evaluate its discriminating ability. Result A total of 303 patients were included; 101 in NF group and 202 in non-NF group. We added serum lactate and comorbid liver disease to the original LRINEC score and re-defined the cut-off values for 3 variables to develop the MLRINEC score. The cut-off value for MLRINEC score was 12 points with corresponding sensitivity of 91.8% and a specificity of 88.4%, and the area under ROC (AUC) was 0.893 (95% CI, 0.723 to 0.948; p < 0.01). Conclusion MLRINEC score shows a high sensitivity and specificity in distinguishing NF from non-necrotizing soft-tissue infections. Patients with a MLRINEC score > 12 points should be highly suspected of presence of necrotizing fasciitis.https://doi.org/10.1186/s13017-021-00373-0Necrotizing fasciitisModified LRINECPredictor |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Po-Han Wu Kai-Hsiang Wu Cheng-Ting Hsiao Shu-Ruei Wu Chia-Peng Chang |
spellingShingle |
Po-Han Wu Kai-Hsiang Wu Cheng-Ting Hsiao Shu-Ruei Wu Chia-Peng Chang Utility of modified Laboratory Risk Indicator for Necrotizing Fasciitis (MLRINEC) score in distinguishing necrotizing from non-necrotizing soft tissue infections World Journal of Emergency Surgery Necrotizing fasciitis Modified LRINEC Predictor |
author_facet |
Po-Han Wu Kai-Hsiang Wu Cheng-Ting Hsiao Shu-Ruei Wu Chia-Peng Chang |
author_sort |
Po-Han Wu |
title |
Utility of modified Laboratory Risk Indicator for Necrotizing Fasciitis (MLRINEC) score in distinguishing necrotizing from non-necrotizing soft tissue infections |
title_short |
Utility of modified Laboratory Risk Indicator for Necrotizing Fasciitis (MLRINEC) score in distinguishing necrotizing from non-necrotizing soft tissue infections |
title_full |
Utility of modified Laboratory Risk Indicator for Necrotizing Fasciitis (MLRINEC) score in distinguishing necrotizing from non-necrotizing soft tissue infections |
title_fullStr |
Utility of modified Laboratory Risk Indicator for Necrotizing Fasciitis (MLRINEC) score in distinguishing necrotizing from non-necrotizing soft tissue infections |
title_full_unstemmed |
Utility of modified Laboratory Risk Indicator for Necrotizing Fasciitis (MLRINEC) score in distinguishing necrotizing from non-necrotizing soft tissue infections |
title_sort |
utility of modified laboratory risk indicator for necrotizing fasciitis (mlrinec) score in distinguishing necrotizing from non-necrotizing soft tissue infections |
publisher |
BMC |
series |
World Journal of Emergency Surgery |
issn |
1749-7922 |
publishDate |
2021-05-01 |
description |
Abstract Background We conducted this study to promote a modified Laboratory Risk Indicator for Necrotizing Fasciitis (MLRINEC) score and evaluate the utility in distinguishing necrotizing fasciitis (NF) from other soft-tissue infections. Method A retrospective cohort study of hospitalized patients with NF diagnosed by surgical finding was conducted in two tertiary hospital in southern Taiwan between January 2015 and January 2020. Another group was matched by controls with non-necrotizing soft tissue infections based on time, demographics, and immune status. Data such as infectious location, comorbidities, and laboratory findings were recorded and compared. Logistics regression were used to determine the association with NF after adjustment for confounders and MLRINEC score was developed by then. Receiver operating curve (ROC) and the area under the curve (AUC) were used to evaluate its discriminating ability. Result A total of 303 patients were included; 101 in NF group and 202 in non-NF group. We added serum lactate and comorbid liver disease to the original LRINEC score and re-defined the cut-off values for 3 variables to develop the MLRINEC score. The cut-off value for MLRINEC score was 12 points with corresponding sensitivity of 91.8% and a specificity of 88.4%, and the area under ROC (AUC) was 0.893 (95% CI, 0.723 to 0.948; p < 0.01). Conclusion MLRINEC score shows a high sensitivity and specificity in distinguishing NF from non-necrotizing soft-tissue infections. Patients with a MLRINEC score > 12 points should be highly suspected of presence of necrotizing fasciitis. |
topic |
Necrotizing fasciitis Modified LRINEC Predictor |
url |
https://doi.org/10.1186/s13017-021-00373-0 |
work_keys_str_mv |
AT pohanwu utilityofmodifiedlaboratoryriskindicatorfornecrotizingfasciitismlrinecscoreindistinguishingnecrotizingfromnonnecrotizingsofttissueinfections AT kaihsiangwu utilityofmodifiedlaboratoryriskindicatorfornecrotizingfasciitismlrinecscoreindistinguishingnecrotizingfromnonnecrotizingsofttissueinfections AT chengtinghsiao utilityofmodifiedlaboratoryriskindicatorfornecrotizingfasciitismlrinecscoreindistinguishingnecrotizingfromnonnecrotizingsofttissueinfections AT shurueiwu utilityofmodifiedlaboratoryriskindicatorfornecrotizingfasciitismlrinecscoreindistinguishingnecrotizingfromnonnecrotizingsofttissueinfections AT chiapengchang utilityofmodifiedlaboratoryriskindicatorfornecrotizingfasciitismlrinecscoreindistinguishingnecrotizingfromnonnecrotizingsofttissueinfections |
_version_ |
1721420285930897408 |