Deep neck space infections: Risk factors related with length of stay and presence of complications

Authors

  • Filipa Ferreira Hospital Garcia de Orta, Portugal
  • Ricardo São Pedro Hospital Garcia de Orta, Portugal https://orcid.org/0000-0002-4129-5154
  • Vitor Proença Hospital Garcia de Orta, Portugal
  • Luis Antunes Hospital Garcia de Orta, Portugal

DOI:

https://doi.org/10.34631/sporl.869

Keywords:

cervical abcess, deep neck space infection, length of stay, complications

Abstract

Objectives: Analyse risk factors related to length of stay in a selection of patients with cervical abscesses and identify predictors for complications. 

Study design: Retrospective study. 

Material and methods: Study of cervical abscesses in adults admitted to the ENT service at Hospital Garcia Orta from 2014 to 2019. 

Results and Conclusions: 146 patients were identified. Advanced age, comorbidities such as hypertension or diabetes, dyspnoea on admission, size of the abscess, non-periamygdalin location, need to change antibiotic or non-transoral drainage route were statistically associated with longer hospital stay and complications. Creatinine, urea and increased CRP at admission were identified as predictors of complications. 

The approach to patients with suspected cervical abscess should consider the assessment of factors that may alert to a higher risk of complications or to a longer hospital stay, as shown in the present study. 

References

Priyamvada S, Motwani G. A Study on Deep Neck Space Infections. Indian J Otolaryngol Head Neck Surg. 2019;71(Suppl 1):912-7. doi 10.1007/s12070-019-01583-4

Maharaj S, Ahmed S, Pillay P. Deep Neck Space Infections: A Case Series and Review of the Literature. Clin Med Insights Ear Nose Throat.

; 12:1179550619871274. doi: 10.1177/1179550619871274

Li RM, Kiemeney M. Infections of the Neck. Emerg Med Clin North Am. 2019;37(1):95-107. doi: 10.1016/j.emc.2018.09.003

Hansen BW, Ryndin S, Mullen KM. Infections of Deep Neck Spaces. Semin Ultrasound CT MR. 2020;41(1):74-84. doi: 10.1053/j.sult.2019.10.001

Russell MD, Russell MS. Urgent Infections of the Head and Neck. Med Clin North Am. 2018;102(6):1109-20. doi: 30342612

Velhonoja J, Laaveri M, Soukka T, Irjala H, Kinnunen I. Deep neck space infections: an upward trend and changing characteristics. Eur Arch Otorhinolaryngol. 2020;277(3):863-72. doi: 10.1007/s00405-019-05742-9

Rzepakowska A, Rytel A, Krawczyk P, Osuch-Wojcikiewicz E, Widlak I, Deja M, et al. The Factors Contributing to Efficiency in Surgical Management of Purulent Infections of Deep Neck Spaces. Ear Nose Throat J. 2019:145561319877281. doi: 10.1177/0145561319877281

Brito TP, Hazboun IM, Fernandes FL, Bento LR, Zappelini CEM, Chone CT, et al. Deep neck abscesses: study of 101 cases. Braz J Otorhinolaryngol. 2017;83(3):341-8. doi: 10.1016/j.bjorl.2016.04.004

Buckley J, Harris AS, Addams-Williams J. Ten years of deep neck space abscesses. J Laryngol Otol. 2019;133(4):324-8. doi: 10.1017/s0022215119000458

Ban MJ, Jung JY, Kim JW, Park KN, Lee SW, Koh YW, et al. A clinical prediction score to determine surgical drainage of deep neck infection: A retrospective case-control study. Int J Surg. 2018;52:131-5. doi: 10.1016/j.ijsu.2018.02.024

Marioni G, Fasanaro E, Favaretto N, Trento G, Giacomelli L, Stramare R, et al. Are panels of clinical, laboratory, radiological, and microbiological variables of prognostic value in deep neck infections? An analysis of 301 consecutive cases. Acta Otolaryngol. 2019;139(2):214-8. doi: 10.1080/00016489.2018.1532606

O'Brien KJ, Snapp KR, Dugan AJ, Westgate PM, Gupta N. Risk factors affecting length of stay in patients with deep neck space infection. Laryngoscope. 2019. doi: 10.1002/lary.28367

Trindade Soares M, Costa E, Durão C, Henriques P, Gabão Veiga V. Infecções cervicais profundas, casuística do serviço de otorrinolaringologia do Hospital Prof. Doutor Fernando Fonseca. Revista Portuguesa de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço. 2015;53(3):161-5. doi: 10.34631/sporl.594

Almutairi DM, Alqahtani RM, Alshareef N, Alghamdi YS, Al-Hakami HA, Algarni M. Deep Neck Space Infections: A Retrospective Study of 183 Cases at a Tertiary Hospital. Cureus. 2020;12(2):e6841. doi: 10.7759/cureus.6841

Butler SO, Btaiche IF, Alaniz C. Relationship between hyperglycemia and infection in critically ill patients. Pharmacotherapy. 2005;25(7):963-76. doi: 10.1592/phco.2005.25.7.963

Martinez Pascual P, Pinacho Martinez P, Friedlander E, Martin Oviedo C, Scola Yurrita B. Peritonsillar and deep neck infections: a review of 330 cases. Braz J Otorhinolaryngol. 2018;84(3):305-10. doi: 10.1016/j.bjorl.2017.03.008

Windfuhr JP, Chen YS. Hospital admissions for acute throat and deep neck infections versus tonsillectomy rates in Germany. Eur Arch Otorhinolaryngol. 2019;276(9):2519-30. doi: 10.1007/s00405-019-05509-2

Lau AS, Upile NS, Wilkie MD, Leong SC, Swift AC. The rising rate of admissions for tonsillitis and neck space abscesses in England, 1991-2011. Ann R Coll Surg Engl. 2014;96(4):307-10. doi: 10.1308/003588414x13946184900363

Estêvão R, Caselhos S, Veloso Teles R, Castro e Sousa A, Henriques V, Matos C, et al. Infecções periamigdalinas e cervicais profundas - Estudo prospectivo. Revista Portuguesa de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço. 2014;52(3):133-8. doi: 10.34631/sporl.447

Wang LF, Kuo WR, Tsai SM, Huang KJ. Characterizations of lifethreatening deep cervical space infections: a review of one hundred ninety-six cases. Am J Otolaryngol. 2003;24(2):111-7. doi: 10.1053/ajot.2003.31

Kimura A, Miyamoto S, Yamashita T. Clinical predictors of descending necrotizing mediastinitis after deep neck infections. Laryngoscope. 2019. doi: 10.1002/lary.28406

Published

2021-03-07

How to Cite

Ferreira, F., São Pedro, R., Proença, V., & Antunes, L. (2021). Deep neck space infections: Risk factors related with length of stay and presence of complications. Portuguese Journal of Otorhinolaryngology and Head and Neck Surgery, 59(1), 31–39. https://doi.org/10.34631/sporl.869

Issue

Section

Original Article