Characterizations of life-threatening deep cervical space infections: a review of one hundred ninety-six cases.
OBJECTIVE
The incidence of deep cervical space infections has decreased after the introduction of antibiotics and improvement of oral hygiene, but they still may be lethal especially when life-threatening complications occur. In this article, we try to find out whether there are predisposing factors related to complicated deep cervical space infections and prolonged hospitalization.


METHODS
We conducted a retrospective analysis of medical records of 196 patients with deep neck infections during the period from March 1996 to February 2002. Among the 196 patients, 15 patients developed lethal complications. As for data analysis, multiple regression and logistic regression with dummy variable were used.


RESULTS
In multiple regressions, patients with older age or with neck swelling, trismus, underlying diseases, complications, and C-reactive protein more than 100 microg/mL stayed longer in the hospital, and the P value reached statistical significance (P <.05). In logistic regression, male patients and patients with neck pain had negative correlation, and the P value reached statistical significance (P <.05). Patients with neck swelling and patients with respiratory difficulty had positive correlation, and the P value reached statistical significance (P <.05). That means female patients, patients with neck swelling, and patients with respiratory difficulty were more likely to have complicated deep neck infections.


CONCLUSIONS
Complicated deep neck infections remain potentially fatal, but the morbidity and mortality can be reduced. Doctors should pay more attention to those high-risk patients; they are female patients, patients with neck swelling, and patients with respiratory difficulty.
Wang
Ling-Feng
LF
Department of Otolaryngology, Kaohsiung Medical University, No. 100 Shih-Chuan 1st Road, Kaohsiung City 807, Taiwan.
Kuo
Wen-Rei
WR
Tsai
Shih-Meng
SM
Huang
Kuan-Jung
KJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D016638:Critical Illness; D004322:Drainage / Q000379:methods; D004359:Drug Therapy, Combination / Q000008:administration & dosage; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009333:Neck; D000039:Peritonsillar Abscess / Q000382:microbiology* / Q000401:mortality / Q000628:therapy*; D011336:Probability; D011379:Prognosis; D012044:Regression Analysis; D017703:Retropharyngeal Abscess / Q000382:microbiology* / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D018461:Soft Tissue Infections / Q000382:microbiology / Q000401:mortality / Q000628:therapy; D016019:Survival Analysis; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents