TY - JOUR
T1 - Evaluation of the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score for detecting necrotizing soft tissue infections in patients with diabetes and lower extremity infection
AU - Johnson, Lance J.
AU - Crisologo, Peter A.
AU - Sivaganesan, Siva
AU - Caldwell, Charles C.
AU - Henning, Jordan
N1 - Funding Information:
This publication was published as an abstract at the American College of Foot and Ankle Surgery meeting 2020, San Antonio, Texas, United States of American Australia 19-22/Feb/2020. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2021/1
Y1 - 2021/1
N2 - Aims: The aim of this pilot study was to assess the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC), a scoring system for Necrotizing Soft Tissue Infections, to diagnose Necrotizing Soft Tissue Infections of the lower extremity in patients with diabetes. Methods: Sixty-nine patients with lower extremity infections were prospectively enrolled. The Laboratory Risk Indicator for Necrotizing Fasciitis was calculated and logistic regression was performed for each laboratory value. Results: The Laboratory Risk Indicator for Necrotizing Fasciitis was associated with Necrotizing Soft Tissue Infection diagnosis in patients with diabetes (p = 0.01). Sensitivity, specificity, positive predictive value, and negative predictive value were 100%, 69%, 16.6%, and 100% respectively. Elevated C-reactive protein (OR 1.01, p = 0.02, 95% CI [1.002–1.23]) and white blood cell count (OR 1.34, p < 0.01, 95% CI [1.1–1.7]) were associated with Necrotizing Soft Tissue Infection. Conclusions: The Laboratory Risk Indicator for Necrotizing Fasciitis was useful as a negative predictor of Necrotizing Soft Tissue Infection while C- reactive protein and white blood cell count may have value as individual predictors. We recommend high clinical suspicion of Necrotizing Soft Tissue Infections in diabetics as laboratory evaluation may be non-specific.
AB - Aims: The aim of this pilot study was to assess the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC), a scoring system for Necrotizing Soft Tissue Infections, to diagnose Necrotizing Soft Tissue Infections of the lower extremity in patients with diabetes. Methods: Sixty-nine patients with lower extremity infections were prospectively enrolled. The Laboratory Risk Indicator for Necrotizing Fasciitis was calculated and logistic regression was performed for each laboratory value. Results: The Laboratory Risk Indicator for Necrotizing Fasciitis was associated with Necrotizing Soft Tissue Infection diagnosis in patients with diabetes (p = 0.01). Sensitivity, specificity, positive predictive value, and negative predictive value were 100%, 69%, 16.6%, and 100% respectively. Elevated C-reactive protein (OR 1.01, p = 0.02, 95% CI [1.002–1.23]) and white blood cell count (OR 1.34, p < 0.01, 95% CI [1.1–1.7]) were associated with Necrotizing Soft Tissue Infection. Conclusions: The Laboratory Risk Indicator for Necrotizing Fasciitis was useful as a negative predictor of Necrotizing Soft Tissue Infection while C- reactive protein and white blood cell count may have value as individual predictors. We recommend high clinical suspicion of Necrotizing Soft Tissue Infections in diabetics as laboratory evaluation may be non-specific.
KW - Diabetes
KW - Foot
KW - Limb salvage
KW - Lower extremity
KW - Necrotizing
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U2 - 10.1016/j.diabres.2020.108520
DO - 10.1016/j.diabres.2020.108520
M3 - Article
C2 - 33096188
AN - SCOPUS:85097739539
SN - 0168-8227
VL - 171
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
M1 - 108520
ER -