Prospective Validation and Comparison of Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) and Site Other Than Lower Limb, Immunosuppression, Age, Renal Impairment, and Inflammatory Markers (SIARI) Scoring Systems for Necrotizing Fasciitis IN critically Ill Patients.

Authors

• Talal Ibrahim mostafa Hagag, MD of critical Care Medicine lecturer of critical care medicine Shebin Elkom Teaching Hospital, General Organization for Teaching Hospitals and Institutes.Follow
• Shimaa Mohamed kalama, MD of General Surgery lecturer of general surgery Shebin Elkom Teaching Hospital, General Organization for Teaching Hospitals and Institutes

Abstract

Background Necrotizing soft tissue infections (NSTIs) are rapidly progressive infections that are dangerous to life, with high morbidity and mortality. Prompt surgical and medical management is necessary and stands mostly on precise identification as well as risk stratification. In order to enhance diagnostic as well as prognostic accuracy, prognostic scoring systems like the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) as well as the most recent Site, Immunosuppression, Age, Renal impairment, and inflammatory markers (SIARI) score, were introduced. Methods A prospective observational cohort study was carried out during June-August 2024 in Shebin Elkom Teaching Hospital among 60 patients who had the diagnosis of NSTI. Clinical and laboratory baseline values were taken to estimate LRINEC and SIARI scores. Information regarding modalities of treatment, as well as outcomes, was collected. Predictors of poor outcomes were determined through logistic regression, while diagnostic accuracy was validated through receiver operating characteristic (ROC) curve analysis.Results: It comprised mostly overweight, aged males, and the most common comorbidity was diabetes. Admitted patients had severe systemic disturbances like anemia, hyperglycemia, renal failure, and leukocytosis. Adverse outcomes were associated with high LRINEC and high SIARI scores, high C-reactive protein (CRP), and leukocytosis. ROC analysis indicated that both LRINEC (AUC = 0.996) and SIARI (AUC = 0.988) exhibited outstanding diagnostic performance. LRINEC provided absolute sensitivity as well as negative predictive value, while SIARI provided exemplary specificity along with positive predictive value. Conclusion LRINEC and SIARI scores both exhibited outstanding predictive capability in NSTI. Use together potentially would be helpful in early prediction and assist in making surgical decisions. Validation in larger, multicenter studies will be necessary to confirm these results.

Article Type

Original Study

Subject Area

Anesthesia, Surgical Intensive Care and Pain Treatment

IRB Number

HSH00085

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.

Recommended Citation

Hagag, Talal Ibrahim mostafa and kalama, Shimaa Mohamed (2026) "Prospective Validation and Comparison of Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) and Site Other Than Lower Limb, Immunosuppression, Age, Renal Impairment, and Inflammatory Markers (SIARI) Scoring Systems for Necrotizing Fasciitis IN critically Ill Patients.," Journal of Medicine in Scientific Research: Vol. 9: Iss. 2, Article 11.
DOI: https://doi.org/10.59299/2537-0928.1513