Literature DB >> 34237752

Deep Neck Infections: Demographic and Clinical Factors Associated with Poor Outcomes.

José Luis Treviño-Gonzalez1, Félix Maldonado-Chapa2, Amalia González-Larios2, Josefina Alejandra Morales-Del Angel2, Germán Armando Soto-Galindo2, Jennifer Mística Zafiro García-Villanueva2.   

Abstract

INTRODUCTION: Deep neck infections (DNIs) are abscesses located in the profound spaces of the neck and constitute one of the most common otolaryngological life-threatening emergencies. The aim of this study is to review the clinical and demographic data of patients with DNI and identify factors associated with prolonged hospitalization, reoperation, and mortality.
METHODS: Retrospective review and analysis of 75 patients with DNI admitted from January 2015 to December 2019 in a tertiary referral hospital.
RESULTS: Of 75 patients, 50 (66.6%) were males and 25 (33.3%) females. Age ranged from 18 to 91 years with a mean of 41.79 (±15.48). DNIs were odontogenic in 49 patients (65.3%). History of diabetes mellitus (DM) was positive in 26 patients (34.6%). The submandibular space was involved in 57 patients (76%). Streptococcus spp. were isolated in 35 patients (46%). Intubation for airway preservation was needed in 21 patients (28%) and tracheostomy in 6 (8%). Mediastinitis presented in 8 patients (10.67%), with a mortality rate of 62.5% (n = 5). Mean hospital stay was 9.13 days (±7.2). DM (p = 0.016), age (p = 0.001), BMI classification 3, 4, and 6 (p = 0.041), and intensive care unit (ICU) admission (p = 0.009) were associated with a longer stay. Surgical drainage was performed after 1.71 days (±1.65). Surgical reintervention was needed in 6 cases (8%) and was associated with temporal (p = 0.001) and masticator (p = 0.002) space involvement and DM (p = 0.009). Overall mortality was 8% and decreased to 1.5% when mediastinitis was excluded. Mediastinitis (p = 0.001), ICU admission (p < 0.0001), Streptococcus spp. (p = 0.019), and low hemoglobin levels (p = 0.004) were associated with mortality. DISCUSSION/
CONCLUSION: DNIs are entities associated with high morbimortality. Mediastinitis and airway obstruction are life-threatening possible complications and should be promptly evaluated. Low HB could be used as a predicting factor for mortality.
© 2021 S. Karger AG, Basel.

Entities:  

Keywords:  Deep neck abscess; Deep neck infection; Deep neck spaces; Mediastinitis; Odontogenic infection

Mesh:

Year:  2021        PMID: 34237752     DOI: 10.1159/000517026

Source DB:  PubMed          Journal:  ORL J Otorhinolaryngol Relat Spec        ISSN: 0301-1569            Impact factor:   1.538


  2 in total

1.  Descending Necrotizing Mediastinitis Resulting From Sialadenitis Without Sialolithiasis.

Authors:  Eric Silver; Nicholas Bial; Steve Yusupov
Journal:  Cureus       Date:  2022-05-03

2.  The Changes in the Severity of Deep Neck Infection Post-UPPP and Tonsillectomy in Patients with OSAS.

Authors:  Pin-Ching Hu; Liang-Chun Shih; Wen-Dien Chang; Jung-Nien Lai; Pei-Shao Liao; Chih-Jaan Tai; Chia-Der Lin; Hei-Tung Yip; Te-Chun Shen; Yung-An Tsou
Journal:  Life (Basel)       Date:  2022-08-05
  2 in total

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