Clinical Decision Rules

Clinical decision rules have looked at investigations that may assist in early diagnosis of necrotising fasciitis.

Several studies have suggested that patients with the following are more likely to have necrotising fasciitis than cellulitis: the laboratory indicators of necrotising fasciitis (LRINEC) score is the most widely known, but is not validated (Table 1). A score of six or greater is considered to be suggestive of necrotising fasciitis. However, multiple studies have shown poor sensitivity and specificity for the detection of necrotising fasciitis so it should be used with caution.

Table 1: Laboratory indicators of necrotising fasciitis (14)

Important: Although a score of six or greater suggests necrotising fasciitis, this decision rule has not been convincingly validated and should not override clinical judgement.