[Prognostic value of the LRINEC score (Laboratory Risk Indicator for Necrotizing Fasciitis) in soft tissue infections: a prospective study at Clermont-Ferrand University hospital].
BACKGROUND
The LRINEC score was developed in a retrospective study in order to distinguish necrotizing fasciitis from severe soft tissue infections using laboratory data.


OBJECTIVE
To evaluate the prognostic value of the LRINEC score in infectious cellulitis.


METHODS
A prospective study was performed at the departments of infectious diseases and dermatology of the Clermont-Ferrand University Hospital. The three evaluation criteria were: time from initiation of antibiotics to regression of erythema, duration of fever and occurrence of complications (abscess, surgery, septic shock, necrotizing fasciitis, death, transfer to intensive care). Potential predictive variables were: LRINEC score>6 at admission, comorbidities, local appearance, clinical presentation and soft tissue ultrasound results.


RESULTS
Fifty patients were included. The rate of complications was higher for patients with a LRINEC score>6 (54%) than for patients with a score<6 (12%, P=0.008). However, a LRINEC score>6 on admission was not significantly associated with increased duration of erythema or of fever. Prior lymphoedema was associated with a better prognosis.


CONCLUSIONS
The LRINEC score may be a useful tool for the detection of complicated forms of soft tissue infections. Patients with a LRINEC score>6 on admission should be carefully evaluated (hospitalization, surgical assessment, close monitoring).
Corbin
V
V
Service des maladies infectieuses et tropicales, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France. violainecorbin@yahoo.fr
Vidal
M
M
Beytout
J
J
Laurichesse
H
H
D'Incan
M
M
Souteyrand
P
P
Lesens
O
O
D000038:Abscess / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000150:complications; D003646:Debridement; D042241:Early Diagnosis; D019115:Fasciitis, Necrotizing / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D005260:Female; D005334:Fever / Q000209:etiology; D005602:France / Q000453:epidemiology; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D008209:Lymphedema / Q000150:complications; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000453:epidemiology / Q000209:etiology; D018461:Soft Tissue Infections / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D055815:Young Adult
D000900:Anti-Bacterial Agents