Laboratory Risk Indicator for Necrotizing Fasciitis of the Oro-Cervical Region (LRINEC-OC): A Possible Diagnostic Tool for Emergencies of the Oro-Cervical Region
Aim. Oro-cervical necrotizing fasciitis (OCNF) treatment requires early surgical debridement and opening of the wound, and therefore, early diagnosis is very important. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score based on blood test data has recently been proposed as an au...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Emergency Medicine International |
| Online Access: | http://dx.doi.org/10.1155/2019/1573453 |
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| author | Masaru Ogawa Satoshi Yokoo Yu Takayama Jun Kurihara Takaya Makiguchi Takahiro Shimizu |
| author_facet | Masaru Ogawa Satoshi Yokoo Yu Takayama Jun Kurihara Takaya Makiguchi Takahiro Shimizu |
| author_sort | Masaru Ogawa |
| collection | DOAJ |
| description | Aim. Oro-cervical necrotizing fasciitis (OCNF) treatment requires early surgical debridement and opening of the wound, and therefore, early diagnosis is very important. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score based on blood test data has recently been proposed as an auxiliary diagnostic tool. However, in some cases, it is difficult to diagnose OCNF. We performed a pooled analysis of patients with OCNF at Gunma University Hospital and literature cases, with the goal of designing a new auxiliary diagnostic tool for OCNF by adding physical characteristics of the oro-cervical region to blood test data in the first examination. Methods. Univariate and multivariate logistic regression was used to select predictors of OCNF. The LRINEC-Oro-Cervical (OC) score was then designed using correlation coefficients of items selected in logistic regression analysis. A cutoff value for the LRINEC-OC score was determined using receiver operating characteristic (ROC) curve analysis. Results. CRP, WBC, Cr, and skin flare in the cervical and precordial regions were extracted as independent factors (p<0.05) and evaluated as predictors of OCNF. The LRINEC-OC score for the prediction of OCNF was designed using the regression coefficients in logistic analysis. The cutoff value for the LRINEC-OC score was 6 points with a sensitivity of 88.5% and a specificity of 93.4%, and the AUC was 0.909. Conclusion. Delays in diagnosis and surgical treatment for OCNF led to a fatal prognosis, and the potential utility of the LRINEC-OC score for improving the prognosis was shown in this study. |
| format | Article |
| id | doaj-art-00fd536379954042b7b94be70289d3fc |
| institution | Kabale University |
| issn | 2090-2840 2090-2859 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Emergency Medicine International |
| spelling | doaj-art-00fd536379954042b7b94be70289d3fc2025-02-03T01:30:53ZengWileyEmergency Medicine International2090-28402090-28592019-01-01201910.1155/2019/15734531573453Laboratory Risk Indicator for Necrotizing Fasciitis of the Oro-Cervical Region (LRINEC-OC): A Possible Diagnostic Tool for Emergencies of the Oro-Cervical RegionMasaru Ogawa0Satoshi Yokoo1Yu Takayama2Jun Kurihara3Takaya Makiguchi4Takahiro Shimizu5Department of Oral and Maxillofacial Surgery and Plastic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, JapanDepartment of Oral and Maxillofacial Surgery and Plastic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, JapanDepartment of Oral and Maxillofacial Surgery and Plastic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, JapanDepartment of Oral and Maxillofacial Surgery and Plastic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, JapanDepartment of Oral and Maxillofacial Surgery and Plastic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, JapanDepartment of Oral and Maxillofacial Surgery and Plastic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, JapanAim. Oro-cervical necrotizing fasciitis (OCNF) treatment requires early surgical debridement and opening of the wound, and therefore, early diagnosis is very important. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score based on blood test data has recently been proposed as an auxiliary diagnostic tool. However, in some cases, it is difficult to diagnose OCNF. We performed a pooled analysis of patients with OCNF at Gunma University Hospital and literature cases, with the goal of designing a new auxiliary diagnostic tool for OCNF by adding physical characteristics of the oro-cervical region to blood test data in the first examination. Methods. Univariate and multivariate logistic regression was used to select predictors of OCNF. The LRINEC-Oro-Cervical (OC) score was then designed using correlation coefficients of items selected in logistic regression analysis. A cutoff value for the LRINEC-OC score was determined using receiver operating characteristic (ROC) curve analysis. Results. CRP, WBC, Cr, and skin flare in the cervical and precordial regions were extracted as independent factors (p<0.05) and evaluated as predictors of OCNF. The LRINEC-OC score for the prediction of OCNF was designed using the regression coefficients in logistic analysis. The cutoff value for the LRINEC-OC score was 6 points with a sensitivity of 88.5% and a specificity of 93.4%, and the AUC was 0.909. Conclusion. Delays in diagnosis and surgical treatment for OCNF led to a fatal prognosis, and the potential utility of the LRINEC-OC score for improving the prognosis was shown in this study.http://dx.doi.org/10.1155/2019/1573453 |
| spellingShingle | Masaru Ogawa Satoshi Yokoo Yu Takayama Jun Kurihara Takaya Makiguchi Takahiro Shimizu Laboratory Risk Indicator for Necrotizing Fasciitis of the Oro-Cervical Region (LRINEC-OC): A Possible Diagnostic Tool for Emergencies of the Oro-Cervical Region Emergency Medicine International |
| title | Laboratory Risk Indicator for Necrotizing Fasciitis of the Oro-Cervical Region (LRINEC-OC): A Possible Diagnostic Tool for Emergencies of the Oro-Cervical Region |
| title_full | Laboratory Risk Indicator for Necrotizing Fasciitis of the Oro-Cervical Region (LRINEC-OC): A Possible Diagnostic Tool for Emergencies of the Oro-Cervical Region |
| title_fullStr | Laboratory Risk Indicator for Necrotizing Fasciitis of the Oro-Cervical Region (LRINEC-OC): A Possible Diagnostic Tool for Emergencies of the Oro-Cervical Region |
| title_full_unstemmed | Laboratory Risk Indicator for Necrotizing Fasciitis of the Oro-Cervical Region (LRINEC-OC): A Possible Diagnostic Tool for Emergencies of the Oro-Cervical Region |
| title_short | Laboratory Risk Indicator for Necrotizing Fasciitis of the Oro-Cervical Region (LRINEC-OC): A Possible Diagnostic Tool for Emergencies of the Oro-Cervical Region |
| title_sort | laboratory risk indicator for necrotizing fasciitis of the oro cervical region lrinec oc a possible diagnostic tool for emergencies of the oro cervical region |
| url | http://dx.doi.org/10.1155/2019/1573453 |
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