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Strongly favor this test or intervention.

The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score is a tool used to evaluate the likelihood of necrotizing fasciitis, a serious bacterial skin infection. This tool considers six laboratory parameters: C-reactive protein (CRP), white blood cell count (WBC), hemoglobin, sodium, creatinine, and glucose. Each of these factors contributes to the LRINEC score based on its value.

- C-reactive protein:
  - Less than 15 mg/dL (150 mg/L) scores 0
  - 15 mg/dL (150 mg/L) or greater scores 4

- White blood cell count:
  - Less than 15,000/mcL scores 0
  - Between 15,000 and 25,000/mcL scores 1
  - Greater than 25,000/mcL scores 2

- Hemoglobin:
  - Greater than 13.5 g/dL scores 0
  - Between 11 and 13.5 g/dL scores 1
  - Less than 11 scores 2

- Sodium:
  - 135 mmol/L or greater scores 0
  - Less than 135 mmol/L scores 2

- Creatinine:
  - 1.6 mg/dL (141 mcmol/L) or less scores 0
  - Greater than 1.6 mg/dL (141 mcmol/L) scores 2

- Glucose:
  - 180 mg/dL (10 mmol/L) or less scores 0
  - Greater than 180 mg/dL (10 mmol/L) scores 1

To find the final LRINEC score, each parameter is assigned a score according to the values listed. All individual scores are summed, resulting in a total score that falls between 0 and 13. This total score helps evaluate the risk of necrotizing fasciitis:

- Scores from 0 to 5 indicate a low risk.
- Scores of 6 or 7 suggest an intermediate risk.
- Scores 8 or above signify a high risk.

Interpreting the LRINEC score enables healthcare professionals to assess the potential risk of necrotizing fasciitis, providing insight that may guide further diagnostic procedures or treatment decisions.

The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score is a clinical calculator used to assess the risk of necrotizing fasciitis, a severe type of soft tissue infection, in patients presenting with severe skin and soft tissue infections. The LRINEC score is calculated based on six laboratory values: C-reactive protein (CRP), white blood cell count (WBC), hemoglobin, sodium, creatinine, and glucose levels. 

This calculator is applicable to patients with severe skin and soft tissue infections where there is a suspicion of necrotizing fasciitis. The clinical utility of the LRINEC score is to aid in the early identification of necrotizing fasciitis, which is critical as this condition can rapidly progress and become life-threatening. 

The LRINEC score may not be applicable or accurate in patients with underlying conditions that can affect the laboratory values used in the score, such as chronic kidney disease (which can affect creatinine levels) or diabetes (which can affect glucose levels). It should also be noted that a low LRINEC score does not completely rule out necrotizing fasciitis, and clinical judgment should always be used in conjunction with this scoring system.

Necrotizing fasciitis

Background

Overview

Guidelines

Key sources