Accuracy of Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score System as An Early Diagnostic Predictor of Necrotizing Fasciitis in A Tertiary Referral Hospital in Bandung, Indonesia

Background: Necrotizing fasciitis (NF) is a serious infection that can rapidly kill tissue and potentially lead to multiple organ failure. Early diagnosis and treatment are essential for survival. The laboratory risk indicator for necrotizing fasciitis (LRINEC) score may aid in early detection of NF...

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Main Authors: Teguh Marfen Djajakusumah, Rani Septrina, Arief Dwinanda
Format: Article
Language:English
Published: Universitas Padjadjaran 2024-09-01
Series:Althea Medical Journal
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Online Access:https://journal.fk.unpad.ac.id/index.php/amj/article/view/3341
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author Teguh Marfen Djajakusumah
Rani Septrina
Arief Dwinanda
author_facet Teguh Marfen Djajakusumah
Rani Septrina
Arief Dwinanda
author_sort Teguh Marfen Djajakusumah
collection DOAJ
description Background: Necrotizing fasciitis (NF) is a serious infection that can rapidly kill tissue and potentially lead to multiple organ failure. Early diagnosis and treatment are essential for survival. The laboratory risk indicator for necrotizing fasciitis (LRINEC) score may aid in early detection of NF. Although initially promising, studies on the effectiveness of LRINEC have shown mixed results. This study aimed to investigate the accuracy of LRINEC in predicting NF. Methods: This was an observational prospective cohort study, including patients with NF as well as skin and soft tissue infection (SSTI) who were treated at a tertiary referral hospital in Bandung, Indonesia in 2022. The LRINEC scores was calculated to measure sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The accuracy of LRINEC scores was specified in the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. Results: Of the total 70 patients, 33 were diagnosed with NF and 37 with SSTI. The LRINEC score with ≥6 points cut-off showed a sensitivity of 90.9% (95%CI; 75.67–98.08%), specificity of 75.60% (95%CI; 58.80–88.23%), PPV of 76.9% (95%CI; 60.67–88.87%), and NPV 90.30% (95%CI; 74.25–97.96%). The area under the ROC (AUROC) curve for the accuracy of the LRINEC scores was 0.895 (95%CI; 0.821–0.969). Conclusions: The laboratory risk indicator for necrotizing fasciitis (LRINEC) score is an accurate predictor and feasible early diagnostic indicator in NF. However, clinical judgment remains a crucial factor in diagnosing NF.
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spelling doaj-art-0d406cd8e19c459eb0c27fa5ccb1e0332025-08-20T02:48:54ZengUniversitas PadjadjaranAlthea Medical Journal2337-43302024-09-0111318819510.15850/amj.v11n3.33411781Accuracy of Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score System as An Early Diagnostic Predictor of Necrotizing Fasciitis in A Tertiary Referral Hospital in Bandung, IndonesiaTeguh Marfen Djajakusumah0Rani Septrina1Arief Dwinanda2Division of Vascular and Endovascular Surgery, Department of Surgery, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, BandungDivision of Plastic and Esthetic Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, BandungDepartment of Surgery, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, BandungBackground: Necrotizing fasciitis (NF) is a serious infection that can rapidly kill tissue and potentially lead to multiple organ failure. Early diagnosis and treatment are essential for survival. The laboratory risk indicator for necrotizing fasciitis (LRINEC) score may aid in early detection of NF. Although initially promising, studies on the effectiveness of LRINEC have shown mixed results. This study aimed to investigate the accuracy of LRINEC in predicting NF. Methods: This was an observational prospective cohort study, including patients with NF as well as skin and soft tissue infection (SSTI) who were treated at a tertiary referral hospital in Bandung, Indonesia in 2022. The LRINEC scores was calculated to measure sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The accuracy of LRINEC scores was specified in the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. Results: Of the total 70 patients, 33 were diagnosed with NF and 37 with SSTI. The LRINEC score with ≥6 points cut-off showed a sensitivity of 90.9% (95%CI; 75.67–98.08%), specificity of 75.60% (95%CI; 58.80–88.23%), PPV of 76.9% (95%CI; 60.67–88.87%), and NPV 90.30% (95%CI; 74.25–97.96%). The area under the ROC (AUROC) curve for the accuracy of the LRINEC scores was 0.895 (95%CI; 0.821–0.969). Conclusions: The laboratory risk indicator for necrotizing fasciitis (LRINEC) score is an accurate predictor and feasible early diagnostic indicator in NF. However, clinical judgment remains a crucial factor in diagnosing NF.https://journal.fk.unpad.ac.id/index.php/amj/article/view/3341lrinec scores, necrotizing fasciitis, skin and soft tissue infection
spellingShingle Teguh Marfen Djajakusumah
Rani Septrina
Arief Dwinanda
Accuracy of Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score System as An Early Diagnostic Predictor of Necrotizing Fasciitis in A Tertiary Referral Hospital in Bandung, Indonesia
Althea Medical Journal
lrinec scores, necrotizing fasciitis, skin and soft tissue infection
title Accuracy of Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score System as An Early Diagnostic Predictor of Necrotizing Fasciitis in A Tertiary Referral Hospital in Bandung, Indonesia
title_full Accuracy of Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score System as An Early Diagnostic Predictor of Necrotizing Fasciitis in A Tertiary Referral Hospital in Bandung, Indonesia
title_fullStr Accuracy of Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score System as An Early Diagnostic Predictor of Necrotizing Fasciitis in A Tertiary Referral Hospital in Bandung, Indonesia
title_full_unstemmed Accuracy of Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score System as An Early Diagnostic Predictor of Necrotizing Fasciitis in A Tertiary Referral Hospital in Bandung, Indonesia
title_short Accuracy of Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score System as An Early Diagnostic Predictor of Necrotizing Fasciitis in A Tertiary Referral Hospital in Bandung, Indonesia
title_sort accuracy of laboratory risk indicator for necrotizing fasciitis lrinec score system as an early diagnostic predictor of necrotizing fasciitis in a tertiary referral hospital in bandung indonesia
topic lrinec scores, necrotizing fasciitis, skin and soft tissue infection
url https://journal.fk.unpad.ac.id/index.php/amj/article/view/3341
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