What Is the Accuracy of Physical Examination, Imaging, and the LRINEC Score for the Diagnosis of Necrotizing Soft Tissue Infection?

Of 2,290 initial citations, the authors included 23 studies including 16 retrospective cohort studies, 2 prospective cohort studies, and 5 retrospective case-control studies. Pooled sensitivity values for physical examination findings ranged from 21.0% for hypotension to 46.0% for fever (Table). The sensitivity of CT presence of fascial edema, fascial enhancement, or fascial gas was significantly higher than the sensitivity of radiography (94.3% versus 48.9%). Finally, the sensitivity of LRINEC scores was poor, although the specificity for scores greater than or equal to 8 was very good (94.9%).

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