A Clinical Study on Deep Neck Infection

Ohata, Atsushi; Kikuchi, Shigeru; Yoshinami, Hiroyoshi; Takegoshi, Hideki; Aoki, Daisuke; Shigeta, Kei-ichi; Ohno, Toshiya; Tani, Yasuhiro

doi:10.3950/jibiinkoka.109.587

Cited by 19 publications

(3 citation statements)

References 3 publications

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“…Second, several studies have found that patients with diabetes spend longer periods of time in the hospital than those without . In the present meta‐analysis, the mean difference between hospitalization periods was significantly longer in patients with diabetes than in nondiabetic patients, with significant heterogeneity among studies (Table ).…”

Section: Discussionmentioning

confidence: 63%

“…After excluding 9 reports addressing duplicate results, 16 reports were noted to have addressed the clinical features of deep neck infection without clarifying differences between diabetic and nondiabetic groups of patients. Quantitative synthesis was performed on the remaining 20 eligible studies . The study by Srivanitchapoom et al categorized 177 patients into those with diabetes mellitus or human immunodeficiency virus (HIV; n = 34) and an immunocompetent host group.…”

Section: Resultsmentioning

confidence: 99%

“…Diabetes mellitus is considered to adversely impact the immune system, along with causing vascular insufficiency . Although several reports have described clinical features of deep neck infection in patients with diabetes compared to nondiabetic patients, all such reports have been retrospective observational studies, including our own previous report . Systematic reviews and meta‐analyses are essential for developing new hypotheses that can then be tested in interventional studies .…”

Section: Discussionmentioning

confidence: 99%

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Clinical and bacteriological influence of diabetes mellitus on deep neck infection: Systematic review and meta‐analysis

et al. 2014

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Section: Discussionmentioning

confidence: 63%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinical and bacteriological influence of diabetes mellitus on deep neck infection: Systematic review and meta‐analysis

et al. 2014

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Intensive Care Unit Transfer in Patients With Deep Neck Infections

Hung,

Ho,

Chan

et al. 2024

Ear Nose Throat J

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Background: Deep neck infection (DNI) involves the deep neck spaces and may lead to airway compromise. An intensive care unit (ICU) is a specialized unit of the hospital that provides intensive care. ICU care is required for patients with severe DNI, although the risk factors for need of ICU care in patients with DNI have not been investigated. Methods: The clinical and laboratory parameters of 350 patients aged >18 years who were diagnosed with DNI between October 2018 and October 2023 were evaluated. Of these patients, 62 were transferred to the ICU. Univariate and multivariate analyses were applied to assess the risk factors for need of ICU care. Results: Univariate analysis revealed that older age [odds ratio (OR) = 1.0324, 95% confidence interval (CI): 1.0155-1.0496, P = .0001], a higher C-reactive protein (CRP) level (OR = 1.0076, 95% CI: 1.0049-1.0103, P < .0001), and blood glucose level (OR = 1.0057, 95% CI: 1.0023-1.0091, P = .0011), involvement ≥3 spaces (OR = 2.2366, 95% CI: 1.2827-3.8998, P = .0046), and mediastinitis (OR = 4.7134, 95% CI: 2.3537-9.4391, P < .0001) were significant risk factors for ICU transfer in patients with DNI. In multivariate analysis, older age (OR = 1.0216, 95% CI: 1.0032-1.0403, P = .0210), higher CRP level (OR = 1.0063, 95% CI: 1.0033-1.0092, P < .0001), and mediastinitis (OR = 2.6103, 95% CI: 1.1974-5.6905, P = .0158) were independent risk factors of ICU transfer in patients with DNI. The ICU group had a longer hospital stay (23.98 ± 8.53 vs 7.44 ± 4.24, P < .0001) and higher rate of tracheostomy ( P < .0001) than the non-ICU group. However, there were no significant differences in the rate of incision and drainage open surgery or pathogens between the groups (all P > .05). Conclusions: Elder patients and those with advanced CRP levels and mediastinitis are more likely to be transferred to the ICU, leading to prolonged hospital stays and a higher risk of tracheostomy. Clinicians should assess the patient’s need for ICU transfer and timely manage the airway according to the aforementioned laboratory parameters and complications carefully.

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