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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]
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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 

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