For healthcare professionals
LRINEC score calculator (necrotizing fasciitis)
The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score adds points for six routine blood tests to help tell necrotizing fasciitis from other soft tissue infections. The total runs from 0 to 13. Later studies found that it misses many cases, so a low score does not rule the condition out. This tool is written for clinicians and is not a diagnosis.
Laboratory values
For an adult with a suspected soft tissue infection, using blood tests from the same time. Nothing you enter leaves this page.
What you will see
The LRINEC score from 0 to 13 with the points for each test and the risk group.
Educational only, not medical advice. Not a diagnosis. Decisions belong to the treating team.
Source
The score by Wong CH and colleagues, Critical Care Medicine 2004, with points and risk groups as printed in Pippin M and colleagues, Cureus 2026 (Tables 2 and 3), which is open access (CC BY 4.0). The tests check every threshold and the edges of each risk group.
Validated in
Pippin 2026 is a case report with a review of the evidence. It reports that in the original study a score of 6 had a positive predictive value of 92% and a negative predictive value of 96%, and that later authors often quote a sensitivity of 0.92 and specificity of 0.96 at 6, reconstructed from the original data. We do not quote the original cohort, because the 2004 paper is not open access.
Limits
Later studies found much lower sensitivity: Pippin 2026 cites a sensitivity of 0.43 at a score of 6 in one emergency department and a pooled sensitivity of 0.36 in another review, and describes a surgically confirmed case that scored 5 (low). The score should not be used alone to rule out necrotizing fasciitis. Table 3 of Pippin 2026 prints the high group as 'over 8', while its text says a score of 8 was highly predictive; the tool puts 8 in the high group. Units follow the printed table (CRP in mg/L, creatinine and glucose in mg/dL).
The points
As printed in Pippin 2026, Table 2, adapted from Wong 2004 (Pippin 2026) (Wong 2004):
- C-reactive protein: under 150 mg/L, 0; 150 or more, 4
- White cell count (x103/uL): under 15, 0; 15 to 25, 1; over 25, 2
- Hemoglobin (g/dL): over 13.5, 0; 11 to 13.5, 1; under 11, 2
- Sodium (mmol/L): 135 or more, 0; under 135, 2
- Creatinine (mg/dL): 1.6 or less, 0; over 1.6, 2
- Glucose (mg/dL): 180 or less, 0; over 180, 1
Worked example: CRP 200 mg/L (4), white cell count 18 (1), hemoglobin 12.5 (1), sodium 132 (2), creatinine 1.2 (0) and glucose 150 (0) give 8, the high risk group.
Reading the result
Risk groups: 0 to 5 low, 6 to 7 intermediate, 8 or more high (Pippin 2026). In the original study, a score of 6 increased the likelihood of necrotizing fasciitis and a score of 8 was highly predictive of it (Pippin 2026). Wong and colleagues meant the score to be used with a careful history and examination for unclear soft tissue infections (Pippin 2026). Its sensitivity has fallen in later studies, so it is better at supporting suspicion than at ruling the condition out (Pippin 2026).
Related tools
For a quick sepsis screen at the bedside, use the qSOFA calculator; to grade organ dysfunction, use the SOFA score calculator. Other bedside scores are listed under For healthcare professionals.
Sources
- Wong CH, Khin LW, Heng KS, Tan KC, Low CO. The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections. Crit Care Med. 2004;32(7):1535-1541. doi:10.1097/01.ccm.0000129486.35458.7d. PMID 15241098. Original LRINEC paper (not open access; points taken from Pippin 2026). pubmed.ncbi.nlm.nih.gov/15241098/
- Pippin M, Nguyen S, Shrestha S. Declining diagnostic accuracy of the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score in necrotizing fasciitis: a case report with contemporary evidence review. Cureus. 2026;18:e102159. doi:10.7759/cureus.102159. PMID 41732601. Open access (CC BY 4.0). Table 2 (points), Table 3 (risk groups) and evidence review. pmc.ncbi.nlm.nih.gov/articles/PMC12925613/
Written and maintained by the uncovermyrisk.com editorial team. We do not have a medical reviewer; every claim links to its primary source above. Last reviewed: 2026-11-02. Spotted an error? See About.