LRINEC Score for Necrotizing Fasciitis
Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) uses six common laboratory parameters to differentiate necrotizing fasciitis from other severe soft tissue infections.
Score 0 if ≤150; 4 if >150
Score 0 if <15; 1 if 15-25; 2 if >25
Score 0 if >13.5; 1 if 11-13.5; 2 if <11
Score 0 if ≥135; 2 if <135
Score 0 if ≤1.6; 2 if >1.6 (or >141 µmol/L)
Score 0 if ≤180; 1 if >180 (or >10 mmol/L)
Note: Original study used mg/dL for creatinine and glucose. Conversion: 1.6 mg/dL creatinine ≈ 141 µmol/L; 180 mg/dL glucose ≈ 10 mmol/L.
Scoring Table
| Parameter | Points |
|---|---|
| Crp | ≤150: 0 points >150: 4 points |
| Wbc | <15: 0 points 15-25: 1 points >25: 2 points |
| Hemoglobin | >13.5: 0 points 11-13.5: 1 points <11: 2 points |
| Sodium | ≥135: 0 points <135: 2 points |
| Creatinine | ≤1.6: 0 points >1.6: 2 points |
| Glucose | ≤180: 0 points >180: 1 points |
Interpretation
| Category | Score Range | Action |
|---|---|---|
| ● Low Risk | 0-5 | Continue IV antibiotics and close monitoring. |
| ● Moderate Risk | 6-7 | Strongly consider necrotizing fasciitis; urgent surgical consultation and MRI/frozen biopsy. |
| ● High Risk | 8-13 | High probability of necrotizing fasciitis; immediate operative debridement likely needed. |
References
- The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections. Critical Care Medicine (2004). https://pubmed.ncbi.nlm.nih.gov/15241098/
- Laboratory risk indicator for necrotising fasciitis (LRINEC) score for the assessment of early necrotising fasciitis: a systematic review. PMC / International Journal of Surgery (2017). https://pmc.ncbi.nlm.nih.gov/articles/PMC5449710/
This calculator is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition.
- A LRINEC score <6 does NOT rule out necrotizing fasciitis (10% of NF patients may score <6).
- LRINEC should supplement, not replace, clinical judgment. High clinical suspicion warrants immediate surgical consultation regardless of score.
- Sensitivity and specificity vary widely across validation studies (sensitivity 43-90%, specificity 60-96%).