LRINEC score for Necrotizing fascitis – Mnemonic

The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score is a tool to distinguish ordinary skin infections from necrotizing fasciitis.

lrinec score

Mnemonic: NeC WASH

Na level:

  • <135 mmol/L: 2 points

Creatinine:

  • >1.6 mg/dl: 2 points

WBC:

  • <15,000/cu.mm: 0 points
  • 15,000-25000/cu.mm: 1 point
  • >25,000/cu.mm: 2 points

Acute phase reactant (CRP):

  • >/= 150: 4 points

Sugar:

  • >180 mg/dl (10 mmol/l): 1 point

Hemoglobin:

  • >13.5 g/dl: 0
  • 11-13.5 g/dl: 1
  • <11 g/dl: 2

Remember: All variables have maximum score of 2 except CRP (max. 4) and blood glucose (max. 1). Maximum total score is 13.

Interpretation:

A LRINEC score, a score ≥ 6 is a reasonable cut-off to rule in necrotizing fasciitis, but a LRINEC < 6 does not completely rule out the diagnosis. A score > 6 has PPV of 92% and NPV of 96% for necrotizing fasciitis.

Reference: Wong C. “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(7):1535-41.

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