title: Multi-Space Infections in the Head and Neck: Do Underlying Systemic Diseases Have a Predictive Role in Life-Threatening Complications?
abstract: OBJECTIVE
  To assess the incidence, risk factors, treatment, and outcomes of life-threatening complications of multi-space infections (LCMIs) in the head and neck.
  
  
  METHODS
  This was a retrospective cohort study that enrolled a sample of patients with multi-space infections who were referred from February 2006 through July 2014. The patients were classified into LCMI and non-LCMI groups. The primary predictor in this study was underlying systemic disease. The primary outcome variable was LCMI. Univariate analyses were used for data statistics.
  
  
  RESULTS
  A total of 549 patients were included, and an LCMI was found in 66 patients (12.20%). Descending mediastinitis was the most frequent LCMI (n = 37; 56.06%), followed by airway obstruction (n = 27; 40.91%), pneumonia (n = 12; 18.18%), pericarditis (n = 6; 9.09%), intraorbital infection (n = 2; 3.03%), multiple organ failure (n = 2; 3.03%), intracranial infection (n = 2; 3.03%), and sudden cardiac death (n = 1; 1.52%). Twelve patients with LCMI died during treatment. Elderly patients with an underlying systemic disease more commonly developed an LCMI.
  
  
  CONCLUSIONS
  Multi-space infections in the head and neck can cause several life-threatening complications, and the morbidity of LCMI is considerable. Older age and underlying systemic disease can increase the risk of an LCMI.
authors.affiliation: Resident, Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China; and Department of Oral and Maxillofacial Surgery, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Linjian
authors.initials: L
authors.lastname: Huang
authors.affiliation: Attending Physician, Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Jiang
authors.affiliation: Professor, Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China. Electronic address: caixieyi27@126.com.
authors.forename: Xieyi
authors.initials: X
authors.lastname: Cai
authors.affiliation: Professor, Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
authors.forename: Weijie
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Attending Physician, Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
authors.forename: Wentao
authors.initials: W
authors.lastname: Qian
authors.affiliation: Resident, Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
authors.forename: Yanjie
authors.initials: Y
authors.lastname: Li
authors.affiliation: Professor, Department of Thoracic Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Guan
authors.affiliation: Attending Physician, Department of Thoracic Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Liang
authors.affiliation: Professor, Department of Internal Medicine, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Longnv
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Professor, Department of Internal Medicine, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Professor, Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology. Shanghai, China.
authors.forename: Zhiyuan
authors.initials: Z
authors.lastname: Zhang
mesh_terms: D000038:Abscess / Q000150:complications*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000209:etiology; D001922:Brain Abscess / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D015331:Cohort Studies; D016757:Death, Sudden, Cardiac / Q000209:etiology; D005260:Female; D006257:Head / Q000382:microbiology*; D006801:Humans; D007223:Infant; D008297:Male; D008480:Mediastinitis / Q000209:etiology; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D009333:Neck / Q000382:microbiology*; D009916:Orbital Diseases / Q000209:etiology; D010493:Pericarditis / Q000209:etiology; D011014:Pneumonia / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D018461:Soft Tissue Infections / Q000150:complications*; D055815:Young Adult