title: Cervical Necrotizing Fasciitis--The Value of the Laboratory Risk Indicator for Necrotizing Fasciitis Score as an Indicative Parameter.
abstract: OBJECTIVE
  Cervical necrotizing fasciitis (CNF) is uncommon, difficult to diagnose, and rapidly progressive. The objective of the present study was to determine the predictive value of the laboratory risk indicator for necrotizing fasciitis (LRINEC) score for CNF.
  
  
  METHODS
  The LRINEC score for 16 consecutive cases of CNF and 595 cases of severe non-necrotizing neck infections was determined over a 6.5-year period in a single-center retrospective cohort study and case report. CNF was confirmed by histologic examination and operative report documentation.
  
  
  RESULTS
  Using a cutoff score of 6, the LRINEC score had a sensitivity of 0.94 (95% confidence interval [CI] 0.92 to 0.96) and specificity of 0.94 (95% CI 0.70 to 1.00). The positive predictive value was 0.29 (95% CI 0.17 to 0.44), and the negative predictive value was 0.99 (95% CI 0.99 to 1.00).
  
  
  CONCLUSIONS
  The LRINEC score can detect early cases of CNF. Patients with a LRINEC score of ≥6 must be carefully evaluated for the presence of CNF.
authors.affiliation: Attending Surgeon, Department of Otorhinolaryngology, Head and Neck Surgery, Martin-Luther-University Halle-Wittenberg, Halle, Germany. Electronic address: annett.sandner@uk-halle.de.
authors.forename: Annett
authors.initials: A
authors.lastname: Sandner
authors.affiliation: Attending Intensive Care Physician, Department of Anesthesiology and Surgical Intensive Care Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Moritz
authors.affiliation: Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Unverzagt
authors.affiliation: Professor, Department Head, Department of Otorhinolaryngology, Head and Neck Surgery, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
authors.forename: Stefan K
authors.initials: SK
authors.lastname: Plontke
authors.affiliation: Attending Surgeon, Department of Cardiac and Thoracic Surgery, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
authors.forename: Dietrich
authors.initials: D
authors.lastname: Metz
mesh_terms: D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D003661:Decision Support Techniques; D019115:Fasciitis, Necrotizing / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D006454:Hemoglobins; D002097:C-Reactive Protein