Correlation of LRINEC Scoring System with Histopathological Examination in Assessing the Risk Index for Necrotising Fasciitis in an Indian Tertiary Care Centre

Background: Necrotising fasciitis (NF) is a life-threatening soft tissue infection requiring early diagnosis and aggressive surgical intervention. The Laboratory Risk Indicator for NF (LRINEC) score was introduced to aid early diagnosis using common laboratory parameters. However, its performance in Indian settings requires validation. Objectives: The objective of this study was to evaluate the correlation between LRINEC scoring and histopathological examination (HPE) findings and assess the clinical utility of LRINEC in diagnosing NF. Materials and Methods: A prospective observational study was conducted on 90 patients with suspected NF at a tertiary care hospital. LRINEC scores were calculated using C-reactive protein (CRP), white blood cell, haemoglobin, serum sodium, creatinine, and glucose. Scores were stratified and correlated with intraoperative histopathological findings. Receiver operating characteristic (ROC) curve analysis was used to assess diagnostic accuracy. Results: Among 90 patients, 88.8% were male (mean age: 52.2 years). High LRINEC scores significantly correlated with positive HPE ( P < 0.01). ROC analysis revealed an area under the curve of 0.635 for the LRINEC score predicting NF. CRP and serum sodium were the most predictive components. Mortality increased with higher LRINEC categories. Conclusion: LRINEC score demonstrates a strong correlation with histopathological evidence of NF and serves as a reliable adjunct in early diagnosis in the Indian clinical setting. However, it should be used in conjunction with clinical judgement and not as a stand-alone diagnostic tool.