The Cardiovascular
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LRINEC score for necrotising soft-tissue infection

Laboratory risk indicator for necrotising fasciitis.

LRINEC score for necrotising soft-tissue infection
C-reactive protein (CRP)
White blood cell count
Haemoglobin
Sodium
Creatinine
Glucose
Result0 points

Low risk for necrotising soft-tissue infection. A score >=6 should raise suspicion and >=8 is strongly predictive, but the score cannot exclude the diagnosis — surgical exploration decides.

Risk category
Low risk

When to use

  • Risk-stratifying a severe soft-tissue infection when necrotising fasciitis is a concern.

Formula

Points: CRP >=150 (4); WBC 15-25 (1), >25 (2); Hb 11-13.5 (1), <11 (2); Na <135 (2); creatinine >1.6 mg/dL (2); glucose >180 mg/dL (1). Range 0-13.

Pearls and pitfalls

  • A low score does not rule out necrotising infection; clinical judgement and prompt exploration take priority.
  • >=6 intermediate/high, >=8 high risk in the original derivation.

References

  1. Wong CH, et al. Crit Care Med. 2004;32(7):1535-41.