{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:26:46Z","timestamp":1788348406736,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","issue":"1-2","license":[{"start":{"date-parts":[[2017,3,15]],"date-time":"2017-03-15T00:00:00Z","timestamp":1489536000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2018,1]]},"abstract":"Background<\/jats:title>Soft tissue infections are a major health burden in the Top End of the Northern Territory of Australia. Necrotizing fasciitis (NF<\/jats:styled-content>) is associated with mortality rates from 8 to 40%. Early recognition and aggressive surgical debridement are the cornerstones of successful treatment. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC<\/jats:styled-content>) score, developed by Wong et al<\/jats:italic>., uses six routine biochemical variables to aid early diagnosis. We aim to assess the diagnostic efficacy of the LRINEC<\/jats:styled-content> score in our population.<\/jats:p><\/jats:sec>Methods<\/jats:title>A retrospective review of patients with NF<\/jats:styled-content> between 2005 and 2013 was conducted. A time matched cohort of abscesses\/cellulitis was selected. Admission bloods were used to calculate the LRINEC<\/jats:styled-content> score. An intraoperative finding of NF<\/jats:styled-content> was used as the gold standard definition for comparison. The diagnostic accuracy of the LRINEC<\/jats:styled-content> score was assessed.<\/jats:p><\/jats:sec>Results<\/jats:title>Ninety\u2010eight patients with NF<\/jats:styled-content> and 205 control patients were identified. The area under the receiver operator curve for the LRINEC<\/jats:styled-content> score in detecting NF<\/jats:styled-content> was 0.925 (0.890\u20130.959, P<\/jats:italic> < 0.001). The sensitivity of the LRINEC<\/jats:styled-content> \u22655 for NF<\/jats:styled-content> was 76.3%, with a specificity of 93.1%. The positive and negative predictive values were 95.5 and 88.1%, respectively. The positive and negative likelihood ratios were 11 and 0.25.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>The LRINEC<\/jats:styled-content> score is a useful, robust, non\u2010invasive and easily calculated scoring system that can be used as an adjunct to early diagnosis of NF<\/jats:styled-content>. However, a high degree of clinical suspicion remains the most important factor in early diagnosis of NF<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.13895","type":"journal-article","created":{"date-parts":[[2017,3,15]],"date-time":"2017-03-15T09:13:00Z","timestamp":1489569180000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Laboratory Risk Indicator for Necrotizing Fasciitis score for early diagnosis of necrotizing fasciitis in Darwin"],"prefix":"10.1111","volume":"88","author":[{"given":"Vignesh","family":"Narasimhan","sequence":"first","affiliation":[{"name":"Department of Surgery, Royal Darwin Hospital Darwin Northern Territory, Australia"},{"name":"Department of General Surgery The Alfred Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geraldine","family":"Ooi","sequence":"additional","affiliation":[{"name":"Department of General Surgery The Alfred Hospital Melbourne Victoria Australia"},{"name":"Department of Surgery Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Weidlich","sequence":"additional","affiliation":[{"name":"Department of Surgery, Royal Darwin Hospital Darwin Northern Territory, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip","family":"Carson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Royal Darwin Hospital Darwin Northern Territory, Australia"},{"name":"Flinders University, Northern Territory Medical Program Darwin Northern Territory, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,3,15]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0885066612463680"},{"key":"e_1_2_6_3_1","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.suc.2013.10.011","article-title":"Necrotizing skin and soft tissue infections","volume":"94","author":"Kaafarani HMA","year":"2014","journal-title":"Surg. 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