title: Prognostic factors and effects of early surgical drainage in patients with peritonsillar abscess.
abstract: Peritonsillar abscess is a frequently encountered otorhinolaryngological emergency, but the characteristics of patients with this disease have not been described in detail. The objective of this study was to delineate prognostic factors associated with peritonsillar abscess and the effects of early surgical drainage for the treatment of peritonsillar abscess. We conducted a retrospective analysis of the medical records of 240 consecutive patients with PTA during the period from 2007 to 2013. Univariate analysis indicated that the period between symptom onset and relief was significantly longer in patients with high levels of C-reactive protein (CRP) (>8.53 mg/dL, p = 0.0073) and without early surgical drainage of pus (p < 0.0001). Multivariate analysis identified both of these values as independently associated with longer duration of symptoms (high CRP, P < 0.0001; no early drainage, P < 0.0001). Univariate analysis indicated that the duration between symptom onset and complete recovery from the disease was significantly longer with age ≥40 years (P = 0.0004), no history of recurrent tonsillitis (P = 0.022), high CRP level (P = 0.0017), and no early surgical drainage of the abscess (P = 0.0014). Multivariate analysis identified older age (P = 0.0004), high CRP level (P = 0.0001), and no early drainage (P < 0.0001) as independently associated with longer duration between symptom onset and complete recovery. Early surgical drainage of the abscess is important for the treatment of peritonsillar abscess. Patients ≥40 years old with peritonsillar abscess and high CRP levels should be recognized as a high-risk group.
authors.affiliation: Department of Otolaryngology, Himeji Red Cross Hospital, 12-1 Shimoteno 1-Chome, Himeji City, Hyogo 670-8540, Japan. Electronic address: tomoyasutachibana@hotmail.co.jp.
authors.forename: Tomoyasu
authors.initials: T
authors.lastname: Tachibana
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama City, Okayama 700-8558, Japan.
authors.forename: Yorihisa
authors.initials: Y
authors.lastname: Orita
authors.affiliation: Department of Otolaryngology, Himeji Red Cross Hospital, 12-1 Shimoteno 1-Chome, Himeji City, Hyogo 670-8540, Japan.
authors.forename: Iku
authors.initials: I
authors.lastname: Abe-Fujisawa
authors.affiliation: Department of Otolaryngology, Himeji Red Cross Hospital, 12-1 Shimoteno 1-Chome, Himeji City, Hyogo 670-8540, Japan.
authors.forename: Yuya
authors.initials: Y
authors.lastname: Ogawara
authors.affiliation: Department of Otolaryngology, Himeji Red Cross Hospital, 12-1 Shimoteno 1-Chome, Himeji City, Hyogo 670-8540, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Matsuyama
authors.affiliation: Department of Otolaryngology, Himeji Red Cross Hospital, 12-1 Shimoteno 1-Chome, Himeji City, Hyogo 670-8540, Japan.
authors.forename: Aiko
authors.initials: A
authors.lastname: Shimizu
authors.affiliation: Nakada ENT Clinic, 2-2-20, Shirakuni, Himeji City, Hyogo 670-0808, Japan.
authors.forename: Michihiro
authors.initials: M
authors.lastname: Nakada
authors.affiliation: Department of Pathology, University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama City, Okayama 700-8558, Japan.
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama City, Okayama 700-8558, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Nishizaki
mesh_terms: D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D002097:C-Reactive Protein / Q000378:metabolism*; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D000039:Peritonsillar Abscess / Q000097:blood* / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D002097:C-Reactive Protein
keywords: Incision and drainage; Overall recovery time; Peritonsillar abscess; Prognostic factors; Symptom relief