LRINEC

Q: Which of the following is not part of Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score?

A) C-reactive protein 
B) White blood cell  
C) Hemoglobin  
D) Potassium 
E) Creatinine


Answer: D

NF at the base is a clinical diagnosis. If suspicion for necrotizing fasciitis is high on clinical grounds, the patient should proceed straight to the OR. LRINEC should be calculated in equivocal cases. All of the above are the part of score except potassium. Instead, sodium is included in the score. 135 meq/L is the cutoff point for sodium in LRINEC score. 

LRINEC calculators are available at various web search engines (Ref#2) and very easy to calculate with only five components. A score of 8 has a PPV of 93.4% for NF.

#musculo-skeletal 


References:

1. Wong CH, Khin LW, Heng KS, et al. The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections. Crit Care Med 2004; 32:1535.


2. https://www.mdcalc.com/lrinec-score-necrotizing-soft-tissue-infection#next-steps