Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-28T10:48:04.205Z Has data issue: false hasContentIssue false
  • English
  • Français

Univariate and multivariate models for the prediction of life-threatening complications in 586 cases of deep neck space infections: retrospective multi-institutional study

Published online by Cambridge University Press:  05 June 2017

J Mejzlik ,
P Celakovsky ,
L Tucek ,
M Kotulek ,
A Vrbacky ,
P Matousek ,
L Stanikova ,
T Hoskova ,
A Pazs  and
P Mittu
...Show all authors
J Mejzlik*
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Charles University, Prague
P Celakovsky
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Charles University, Prague
L Tucek
Affiliation:
Department of Dentistry, Faculty of Medicine, University Hospital Hradec Kralove, Charles University, Prague
M Kotulek
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, Pardubice Hospital, Czech Republic
A Vrbacky
Affiliation:
Department of Oral and Maxillofacial Surgery, Pardubice Hospital, Czech Republic
P Matousek
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, University Hospital Ostrava, Czech Republic
L Stanikova
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, University Hospital Ostrava, Czech Republic
T Hoskova
Affiliation:
Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University Hospital Ostrava, Czech Republic
A Pazs
Affiliation:
Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University Hospital Ostrava, Czech Republic
P Mittu
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Charles University, Prague
V Chrobok
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Charles University, Prague
*
Address for correspondence: Dr Jan Mejzlik, Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, University Hospital Hradec Kralove, Charles University, Sokolska 581, Hradec Kralove 500 05, Czech Republic E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To identify deep neck infection factors related to life-threatening complications.

Methods:

This retrospective multi-institutional study comprised 586 patients treated for deep neck infections between 2002 and 2012. The statistical significance of variables associated with life-threatening complications of deep neck infections was assessed.

Results:

During treatment, life-threatening complications occurred in 60 out of 586 cases. On univariate analysis, life-threatening complications were linked to: dyspnoea, neck movement disturbance and dysphonia (all p < 0.001); and parapharyngeal, anterior visceral or pretracheal deep neck involvement (all p < 0.002). Aetiology was significantly linked to tonsils (p < 0.001). Regarding infection type, fasciitis was a significant factor (p < 0.001). Candida albicans was a significant bacterial culture (p < 0.001). A multivariate step-wise model disclosed fewer significant variables: retropharyngeal space (p = 0.005) and major blood vessels area (p = 0.006) involvement, and bacterial culture C albicans (p < 0.001).

Conclusion:

It can be predicted that patients with deep neck infections, with neck movement disturbances, dysphonia, dyspnoea and swelling of the external neck, accompanied by severe pain, and inflammatory changes in the retropharyngeal space and large vessel areas, with culture-confirmed infection of C albicans, are likely to develop life-threatening complications.

Keywords

Multivariate AnalysisRisk FactorsCandida AlbicansFasciitisIncidence
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 9 , September 2017 , pp. 779 - 784
Copyright
Copyright © JLO (1984) Limited 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Boscolo-Rizzo, P, Stellin, M, Muzzi, E, Mantovani, M, Fuson, R, Lupato, V et al. Deep neck infections: a study of 365 cases highlighting recommendations for management and treatment. Eur Arch Otorhinolaryngol 2012;269:1241–9Google Scholar
2 Matzelle, SJ, Heard, AM, Khong, GL, Riley, RH, Eakins, PD. A retrospective analysis of deep neck infections at Royal Perth Hospital. Anaesth Intensive Care 2009;37:604–7Google Scholar
3 Raffaldi, I, Scolfaro, C, Garazzino, S, Peradotto, F, Calitri, C, Tovo, PA. An atypical deep neck infection in a two-year-old child. Infez Med 2014;22:136–9Google Scholar
4 Garca, MF, Budak, A, Demir, N, Cankaya, H, Kiroglu, AF. Characteristics of deep neck infection in children according to weight percentile. Clin Exp Otorhinolaryngol 2014;7:133–7Google Scholar
5 Wang, LF, Tai, CF, Kuo, WR, Chien, CY. Predisposing factors of complicated deep neck infections: 12-year experience at a single institution. J Otolaryngol Head Neck Surg 2010;39:335–41Google Scholar
6 Hidaka, H, Yamaguchi, T, Hasegawa, J, Yano, H, Kakuta, R, Ozawa, D et al. Clinical and bacteriological influence of diabetes mellitus on deep neck infection: systematic review and meta-analysis. Head Neck 2015;37:1536–46CrossRefGoogle ScholarPubMed
7 Huang, T-T, Tseng, F-Y, Yeh, T-H, Hsu, C-J, Chen, Y-S. Factors affecting the bacteriology of deep neck infection: a retrospective study of 128 patients. Acta Otolaryngol 2006;126:396–401 Google Scholar
8 Hasegawa, J, Hidaka, H, Tateda, M, Kudo, T, Sagai, S, Miyazaki, M et al. An analysis of clinical risk factors of deep neck infection. Auris Nasus Larynx 2011;38:101–7CrossRefGoogle ScholarPubMed
9 Maroldi, R, Farina, D, Ravanelli, M, Lombardi, D, Nicolai, P. Emergency imaging assessment of deep neck space infections. Semin Ultrasound CT MR 2012;33:432–42Google Scholar
10 Hegde, AN, Mohan, S, Pandya, A, Shah, GV. Imaging in infections of the head and neck. Neuroimaging Clin N Am 2012;22:727–54CrossRefGoogle ScholarPubMed
11 Wang, B, Gao, BL, Xu, GP, Xiang, C. Images of deep neck space infection and the clinical significance. Acta Radiol 2014;55:945–51Google Scholar
12 Chuang, SY, Lin, HT, Wen, YS, Hsu, FJ. Pitfalls of CT for deep neck abscess imaging assessment: a retrospective review of 162 cases. B-ENT 2013;9:45–52 Google Scholar
13 Staffieri, C, Fasanaro, E, Favaretto, N, Torre, F, Sanguin, S, Giacomelli, L et al. Multivariate approach to investigating prognostic factors in deep neck infections. Eur Arch Otorhinolaryngol 2014;271:2061–7Google ScholarPubMed