LRINEC Score Calculator

With the help of this LRINEC score calculator, you can quickly assess whether your patient is at risk for necrotizing fasciitis​. Apart from calculating the LRINEC score — Laboratory Risk Indicator for Necrotizing Fasciitis — for necrotizing soft tissue infection​, you can also find an LRINEC score interpretation​ for your result and learn more about the signs of sepsis and necrotizing fasciitis treatment​.

We try our best to make our Omni Calculators as precise and reliable as possible. However, this tool can never replace a professional doctor's assessment. If any health condition bothers you, consult a physician.

Necrotizing fasciitis, also known as flesh-eating disease, is a rare but extremely dangerous infection. It happens when bacteria—mainly strep bacteria—infect the tissue beneath the skin, causing it to die. It can start from something as simple as a cut, scrape, or injury anywhere on the body. It's crucial to identify necrotizing fasciitis as soon as possible because it spreads rapidly and can be fatal.

Early symptoms are:

• Severe body pain;
• Fever;
• Chills;
• Nausea; and
• Diarrhea.

Within the next hours or days, other symptoms develop, such as:

• Redness and swelling at the site of infection;
• Skin changes such as discoloration and blisters;
• Unstable blood flow;
• Low blood pressure;
• Tissue death (necrosis); and
• Sepsis.

Necrotizing fasciitis is dangerous and spreads quickly, so early detection is key. Here are some ways to help determine if it's a possibility:

• Clinical symptoms — severe pain and signs of toxicity can hint at the disease;
• Imaging — a CT scan can show abnormalities in the tissue;
• Tissue biopsy — confirms whether bacteria have infected the tissue; and
• LRINEC score — calculates the risk based on blood parameters.

LRINEC stands for Laboratory Risk Indicator for Necrotizing Fasciitis, and is a scoring system designed by researchers. The purpose of this score is to provide a simple tool to differentiate necrotizing fasciitis from other soft tissue infections, based on common lab test results:

1. C-reactive protein — the higher the concentration, the more severe the infection.

2. Total white blood cell count — are elevated upon an infection.

3. Decreased hemoglobin — infections lower the production of red blood cells containing hemoglobin.

4. Decreased sodium — severe infections cause fluid buildup and thus deprivation of electrolytes.

5. Increased creatinine — due to compromised kidney function.

6. High glucose — severe physical stress causes hyperglycemia.

If you want to determine at what risk your patient is for necrotizing fasciitis​, you don't have to calculate the LRINEC score yourself, you can just use our LRINEC score calculator. All you need at hand, are the blood test results of your patient. To use this calculator, add the value range of the following 6 parameters that correspond to your patient's results:

1. C-reactive protein — ≤150 or >150 mg.

2. White blood cell count — <15, 15-25 or >25 mm³.

3. Hemoglobin — <11, 11-13.5 or >13.5 mg/dL.

4. Serum sodium — <135 or ≥135 mEq/L.

5. Creatinine — ≤1.6 or >1.6 mg/dL (1.6 mg/dL = 141 µmol/L).

6. Glucose — ≤180 or >180 mg/dL (180 mg/dL = 10 mmol/L).

7. That's it! You've obtained your LRINEC score for necrotizing soft tissue infection​ at hand with your LRINEC score interpretation​.

Once you've received your LRINEC score, it is time to understand what this is telling us. You can get results from 0 to 15, whereas different blood parameters in different concentrations are weighted individually, as you can derive from this LRINEC score calculation table:

Even though the LRINEC score is a quick and easy tool, it only provides the probability of your patients having necrotizing fasciitis​ and is therefore not a definite diagnosis. However, as time is crucial, it is a reliable method that shows high accuracy for high-risk patients.

The advantage is that it allows you to act quickly and does not require special equipment (such as a CT) or more time-consuming analyzes (such as tissue biopsy).

To know in which risk group your patient belongs, have a look at this LRINEC score interpretation​ table:

If necrotizing fasciitis isn’t diagnosed and treated immediately, it can quickly escalate into another life-threatening condition — sepsis. This occurs when bacteria enter the bloodstream, allowing the infection to spread throughout the body. As a result, vital organs begin to fail, tissues break down, and without urgent medical intervention, the condition can be fatal. The early signs of sepsis are:

• Elevated or lower temperature — of >38 °C or <36 °C;
• Chills and shivering;
• Increased heart rate — over 90 bpm;
• Hyperventilation — >20 breaths per minute; and
• Feeling unwell — extreme fatigue and muscle weakness.

In severe sepsis, blood pressure begins to drop, and multiple organs start to fail.

Once you've diagnosed your patient with necrotizing fasciitis​, it is now time to act fast. Necrotizing fasciitis treatment​ requires:

• Surgery — to remove all dead and infected tissue;

• Initial broad-spectrum antibiotic treatment — to limit the infection;

• Continued narrow-spectrum antibiotic therapy after culture results — for more effective infection management;

• Fluid resuscitation — to restore the hemodynamics in the patient's tissue;

• Pharmacotherapy — to restore a healthy blood pressure; and

• Protein-rich enteral feeding — due to the patient's nutritional deficit.