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Laboratory Risk Indicators for Necrotizing Fasciitis and Associations with Mortality
Elif Colak1, Nuraydin Ozlem1, Gultekin Ozan Kucuk1
1Department of General Surgery, Samsun Training and Research Hospital, Samsun.
Objectives:
Necrotizing fasciitis (NF) is rare but life threatening soft tissue infection characterized by a necrotizing process of the subcutaneous tissues and fascial planes. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score has been verified as a useful diagnostic tool for detecting necrotizing fasciitis. A certain LRINEC score might also be associated with mortality. The aims of this study are to determine risk factors affecting the prognosis and to evaluate the prognostic value of the LRINEC score in NF.
Methods:
Twenty-five patients with necrotizing fasciitis treated in Samsun Education and Research Hospital between January 2008 and April 2013 were enrolled in the study. Surviving and non-surviving patient groups were compared regarding demographic data, co-morbidity, predisposing factors, causative agents, number of debridements and LRINEC score.
Results:
Mean age was 55.6±16.79 years (min: 17-max: 84), and the female/male ratio was 16/9. Mortality was observed in 6 (24%) patients. The most frequent comorbid diseases were diabetes mellitus (52) and peripheral circulatory disorders (24%), and the most frequent etiologies were cutaneous (32%) and perianal abscess (20%). Pseudomonas aeruginosa infection was higher in the non-surviving group (p=0.006). The mean number of debridements and LRINEC score were higher in the non-surviving group than in the surviving group (p=0.003 and p=0.003, respectively).
Conclusions:
Pseudomans aeruginosa infection and multiple debridements are related with mortality. The LRINEC score might help predict mortality in NF.
Insights
Necrotizing fasciitis (NF) is a severe infection where Pseudomonas aeruginosa and multiple debridements indicate higher mortality risk. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score may help predict patient survival in NF cases.
Area of Science:
- Infectious Diseases
- Surgical Pathology
- Critical Care Medicine
Background:
- Necrotizing fasciitis (NF) is a rare, life-threatening soft tissue infection.
- The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score aids in diagnosing NF.
- LRINEC score may correlate with patient mortality.
Purpose of the Study:
- Identify risk factors influencing NF prognosis.
- Evaluate the prognostic capability of the LRINEC score in NF patients.
Main Methods:
- Retrospective study of 25 NF patients (Jan 2008 - Apr 2013).
- Comparison of demographic data, comorbidities, predisposing factors, causative agents, debridement count, and LRINEC scores between survivors and non-survivors.
Main Results:
- Mortality rate was 24% (6/25 patients).
- Diabetes mellitus and peripheral circulatory disorders were common comorbidities.
- Pseudomonas aeruginosa infection, higher LRINEC scores, and increased debridements were associated with mortality (p<0.01).
Conclusions:
- Pseudomonas aeruginosa infection and multiple debridements are linked to mortality in NF.
- The LRINEC score shows potential as a predictor of mortality in necrotizing fasciitis.
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