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J Oral Maxillofac Surg. 2015 Dec;73(12):2319-33. doi: 10.1016/j.joms.2015.05.035. Epub 2015 Jun 5.

Cervical Necrotizing Fasciitis--The Value of the Laboratory Risk Indicator for Necrotizing Fasciitis Score as an Indicative Parameter.

Author information

1
Attending Surgeon, Department of Otorhinolaryngology, Head and Neck Surgery, Martin-Luther-University Halle-Wittenberg, Halle, Germany. Electronic address: annett.sandner@uk-halle.de.
2
Attending Intensive Care Physician, Department of Anesthesiology and Surgical Intensive Care Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
3
Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
4
Professor, Department Head, Department of Otorhinolaryngology, Head and Neck Surgery, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
5
Attending Surgeon, Department of Cardiac and Thoracic Surgery, Martin-Luther-University Halle-Wittenberg, Halle, Germany.

Abstract

PURPOSE:

Cervical necrotizing fasciitis (CNF) is uncommon, difficult to diagnose, and rapidly progressive. The objective of the present study was to determine the predictive value of the laboratory risk indicator for necrotizing fasciitis (LRINEC) score for CNF.

MATERIALS AND METHODS:

The LRINEC score for 16 consecutive cases of CNF and 595 cases of severe non-necrotizing neck infections was determined over a 6.5-year period in a single-center retrospective cohort study and case report. CNF was confirmed by histologic examination and operative report documentation.

RESULTS:

Using a cutoff score of 6, the LRINEC score had a sensitivity of 0.94 (95% confidence interval [CI] 0.92 to 0.96) and specificity of 0.94 (95% CI 0.70 to 1.00). The positive predictive value was 0.29 (95% CI 0.17 to 0.44), and the negative predictive value was 0.99 (95% CI 0.99 to 1.00).

CONCLUSIONS:

The LRINEC score can detect early cases of CNF. Patients with a LRINEC score of ≥6 must be carefully evaluated for the presence of CNF.

PMID:
26079692
DOI:
10.1016/j.joms.2015.05.035
[Indexed for MEDLINE]

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