Evaluación de la escala LRINEC para el diagnóstico de fascitis necrosante en una población latinoamericana.

A retrospective cohort study was conducted in hospitalized patients with skin and soft tissue infections in two high-complexity Colombian institutions between 2016 and 2021. Patients presenting with systemic inflammatory response signs were considered suspected cases of FN and were followed until FN was confirmed or ruled out through surgical description or pathology. The LRINEC score was calculated, and its diagnostic and operational performance was assessed using ROC curves. Results: Among 1,546 clinical records, 29 confirmed cases of FN and 106 suspected cases with FN ruled out were identified. The average LRINEC score in the FN group was 6 points. A score ≥6 points yielded a sensitivity of 62.07%, specificity of 71.7%, and an ROC curve of 0.67; the positive predictive value (PPV) was 37.5% and the negative predictive value (NPV) was 87.36% (positive likelihood ratio [LR+] of 2.19 and negative likelihood ratio [LR–] of 0.52). For a score ≥8 points, sensitivity was 34.48%, specificity 89.62%, and ROC curve 0.62; the PPV was 47.62% and the NPV 83.3% (LR+ of 3.32 and LR– of 0.73).
Conclusions: The diagnostic performance of the LRINEC score in the population studied was moderate and consistent with previous studies. Its greatest utility lies in ruling out the disease, given its high NPV for scores below 6.