What are the Alternatives to the LRINEC Score in Identifying Necrotizing Soft Tissue Infections in the Emergency Department?

Author:

ÇALBAY Ayça1,BAYRAMOĞLU Atıf2,KARADENİZ Erdem2

Affiliation:

1. SBÜ GÜLHANE EĞİTİM VE ARAŞTIRMA HASTANESİ

2. ATATÜRK ÜNİVERSİTESİ, TIP FAKÜLTESİ

Abstract

Objective: The emergency department (ED) is an dynamically high-risk setting. Our aim is to determine the blood parameters associated with necrotizing soft tissue infections (NSTI) to strengthen the LRIEC score. Methods: We analyzed 109 patients who were diagnosed with necrotizing soft tissue infection in the Urology, Dermatology, Plastic surgery and General Surgery clinics of Atatürk University between 2013 and 2016. In the same period, we matched 624 patients diagnosed with cellulitis as a control group. Results: Of four defined clinic's records to Atatürk University Hospital in 2013 to 2016, 109 matched and 624 matched control records were abstracted. Diagnoses associated with the NSTIs were: gangrene (n=47), gas gangrene (n=7), Fournier's gangrene (n=44) and necrotizing fasciitis (n=11). In patients with Necrotizing Soft Tissue Infection, BUN (p=0,00), K (0,011), Neutrofil (p=0,013), Lenfosit (p=0,003), Htc (p=0,00), RDW (p=0,002), Plt (p=0,042), AST (p=0,00), ALT (p=0,00) and INR (p=0,003) values were found to be statistically significant in making the diagnosis. Conclusion: BUN, K, Neutrofil, Lenfosit, Htc, RDW, Plt, AST, ALT and INR values measured from blood tests of patients diagnosed with NSTI can be used in distinctive diagnosis of Soft Tissue Infection (STI). Increased awareness of these values may improve Emergency Department (ED) decision making and prevent miss diagnose.

Publisher

Acil Tip Uzmanlari Dernegi

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