Description

Cribb et al reported the SIARI score for evaluating a patient with necrotizing fasciitis. The authors are from the University of Auckland in New Zealand and Epworth Hospital in Australia.


SIARI is an abbreviation for site, immunosuppression, age, renal, inflammatory markers.

 

Patient selection: necrotizing fasciitis

 

Parameters:

(1) site of infection

(2) history of immunosuppression

(3) age in years

(4) serum creatinine in µmol/L

(5) white blood cell count per microliter

(6) serum C-reactive protein in mg/L

 

Parameter

Finding

Points

site of infection

lower limb

0

 

other than lower limb

3

immunosuppression

no

0

 

yes

3

age in years

<= 60 years

2

 

> 60 years

0

serum creatinine

<= 141 µmol/L

0

 

> 141 µmol/L

1

WBC count

<= 25,000 per µL

0

 

> 25,000 per µL

1

serum C-reactive protein

< 150 mg/L

0

 

>= 150 mg/L

1

 

where:

• WBC count in Tables 3 and 4 refers to 15 and 25 per cubic mm.

total score =

= SUM(points for all of the parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 11

• A score >= 3 has a sensitivity of 84% and specificity of 70%.

 

Performance:

• The area under the ROC curve is 0.85.


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