ORIGINAL ARTICLE   Open

Italian Journal of Emergency Medicine 2020 April;9(1):15-9

DOI: 10.23736/S2532-1285.20.00013-0

Copyright © 2020 THE AUTHORS

This is an open access article under the CC BY-NC-ND license

language: English

LRINEC Score: a novel tool for the stratification of the risk in patients with sepsis from soft tissues infection

Giuseppina PETRELLI ¹ ✉, Elisa PINGIOTTI ², Filippo FELIZIANI ¹, Paolo GIORGINI ¹, Paolo GROFF ³

¹ Division of Emergency Medicine, ASUR Marche, AV 5, Madonna del Soccorso Hospital, San Bendetto del Tronto, Ascoli Piceno, Italy; ² Department of Internal Medicine, ASUR Marche, AV4, Murri Hospital, Fermo, Italy; ³ Department of Emergency Medicine, Santa Maria della Misericordia Hospital, Perugia, Italy

BACKGROUND: Soft-tissue infections generally have subtle symptomatology and high mortality and morbidity for sepsis. The Laboratory risk Indicator for Necrotizing fasciitis or LRINEC score has been proposed to identify early cases at risk of unfavorable evolution. The aim of our study is to evaluate the efficacy of the early application of LRINEC score in the stratification of the risk of sepsis in patients with soft tissue infection.
METHODS: Observational retrospective study conducted on 20 consecutive patients (13 M) aged over 18 years, average age 67±17, admitted to our department of Emergency Medicine between January 2013 and October 2017 with a diagnosis of infection of soft tissues.
RESULTS: The value of the LRINEC score was higher than 5 in 85% of cases. Comorbidities were present in all patients. Patients with the worst outcome had Lrinec Score ≥5 and positive cultures. Positive cultures were associated with higher mortality. Among patients, 17 subjects were discharged in stable conditions, one was admitted to a critical care unit, and two patients died.
CONCLUSIONS: The LRINEC score allows selecting cases at risk of evolution towards sepsis or septic shock in order to undergo early medical treatment and more intensive clinical and instrumental monitoring. The routine application of the LRINEC score requires the activation of a specific quality control system to monitor its effective quality. Large-scale prospective studies are necessary to validate its systematic use.

KEY WORDS: Sepsis; Fasciitis, necrotizing; Erysipelas