Risk factors associated with prolonged hospital length of stay in deep neck infection patients
Article Sidebar
Main Article Content
Abstract
The objective of the study was to analyze risk factors associated with prolonged hospital length of stay in deep neck infection patients. A retrospective, cross-sectional analytic study was conducted in 185 patients with deep neck infection from 1st January 2013-31st December 2015. Chi-square test, Fisher’s exact test and multiple logistic regression were used to analyze associated risk factors of prolonged hospital length of stay in deep neck infection which included demographic and clinical infectious data. For the results, deep neck infection was most commonly found in patients who were elder than 40 years old with male predilection. Odontogenic infection was the most leading cause of infection, whereas the submandibular space was the most affected site. Bacteriologic culture showed that Streptococcus spp. was the most common causative organism. Most patients were admitted for 7 days or less. Risk factors associated with prolonged hospital length of stay included patients with systemic diseases, Ludwig’s angina or lateral pharyngeal space infection, and patients who were intubated postoperatively (p < 0.05). For conclusions, risk factors associated with prolonged hospital length of stay in deep neck infection included some of demographic and clinical infectious factors. Proper care and close monitoring for patients who had these risk factors would decrease length of hospital stay and cost of treatment.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The opinions and content expressed in the articles are solely those of the individual authors and do not necessarily reflect the views of the journal or the authors’ affiliated institutions. Authors are fully responsible for the accuracy and correctness of their work.
Any reuse, reproduction, or redistribution of the articles, content, data, or images in other forms requires prior written permission from the Thai Journal of Oral and Maxillofacial Surgery
References
Har-El G, Aroesty JH, Shaha A, Lucente FE. Changing trends in deep neck abscess: a retrospective study of 110 patients. Oral Surg Oral Med Oral Pathol. 1994;77:446-50.
Lee JK, Kim HD, Lim SC. Predisposing factors of complicated deep neck infection: an analysis of 158 cases. Yonsei Med J. 2007;48:55-62.
Bakir S, Tanriverdi MH, Gün R, Yorgancilar AE, Yildirim M,Tekbaş G, et al. Deep neck space infections: a retrospective review of 173 cases. Am J Otolaryngol. 2012;33: 56-63.
Parhiscar A, Har-El G. Deep neck abscess: a retrospective review of 210 cases. Ann Otol Rhinol Laryngol. 2001; 110:1051-4.
Ridder GJ, Technau I, Sander A, Boedeker CC. Spectrum and management of deep neck space infections: an 8-year experience of 234 cases. Otolaryngol Head Neck Surg. 2005;133:709-14.
Sakarya EU, Kulduk E, Gündogan O, Soy FK, Dündar R, Kılavuz AE, et al. Clinical features of deep neck infection: analysis of 77 patients. Kulak Burun Bogaz Ihtis Derg. 2015;25:102-8.
Wang LF, Kuo WR, Tsai SM, Huang KJ. Characterizations of life-threatening deep cervical space infections: a review of one hundred ninety-six cases. Am J Otolaryngol. 2003; 24:111-7.
Brito TP, Hazboun IM, Fernandes FL, Bento LR, Zappelini CEM, Chone CT, et al. Deep neck abscesses: study of 101 cases. Braz J torhinolaryngol. 2017;83:341-8.
Huang TT, Tseng FY, Yeh TH, Hsu CJ, Chen YS. Factors affecting the bacteriology of deep neck infection: a retrospective study of 128 patients. Acta Otolaryngol. 2006; 126:396-401.
Romsaithong S. Clinical features and predisposing factors for mediastinal extension in deep neck infections. Khonkaen Hospital Med J. 2017;41:152-9.
Chaou CH, Chen HH, Chang SH, Tang P, Pan SL, Yen AM, et al. Predicting length of stay among patients discharged from the emergency department–using an accelerated failure time model. PLoS One. 2017;12:1-11.
Peters FB, Fong B, Wormuth DW, Sonis ST. Risk factors affecting hospital length of stay in patients with odontogenic maxillofacial infections. J Oral Maxillofac Surg. 1996;54:1386-91.
Chen MK, Wen YS, Chang CC, Huang MT, Hsiao HC. Predisposing factors of life-threatening deep neck infection: logistic regression analysis of 214 cases. J Otolaryngol. 1998;27:141-4.
Morimoto Y, Imai Y, Tatebayashi S, Ohgi K, Yamamoto K, Hyomoto M, et al. Risk factors affecting duration of management of odontogenic maxillofacial cellulitis. Asian J Oral Maxillofac Surg. 2003;15:256-60.
Kim MK, Nalliah RP, Lee MK, Allareddy V. Factors associated with length of stay and hospital charges for patients hospitalized with mouth cellulitis. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113:21-8.
Barber BR, Dziegielewsk PT, Biron VL, Ma A, Seikaly H. Factors associated with severe deep neck space infections: targeting multiple fronts. Otolaryngol Head Neck Surg. 2014;43:1-7.
Huang TT, Tseng FY, Liu TC, Hsu CJ, Chen YS. Deep neck infection in diabetic patients: comparison of clinical picture and outcomes with ืnondiabetic patients. Otolaryngol Head Neck Surg. 2005;132:943-7.
Kongtangchit P. Deep neck infection: comparison of clinical course and outcome between diabetic and non-diabetic patients. Thai J otolaryngol Head Neck Surg. 2013;14:35-51.
Rasteniene R, Aleksejuniene J, Puriene A. Determinants of length of hospitalization due to acute odontogenic maxillofacial infections: a 2009-2013 retrospective analysis. Med Princ Pract. 2015;24:129-35.
Stathopoulos P, Igoumenakis D, Shuttleworth J, Smith W, Ameerally P. Predictive factors of hospital stay in patients with odontogenic maxillofacial infections: the role of C-reactiveprotein. Br J Oral Maxillofac Surg. 2017;55: 367-70.
Flynn TR. Principle of management of maxillofacial infection. In: Peterson’s principle of oral and maxillofacial surgery. Shelton, Connecticut: Michael Miloro; 2011. p. 841-60.
Wongnijasil C. Deep neck abscess: clinical review at Khonkaen Hospital. Khonkaen Hospital Med J. 2008;32: 147-54.
Lee YQ, Kanagalingam J. Deep neck abscesses: the Singapore experience. Eur Arch Otorhinolaryngol. 2011;268:609-14
Marioni G, Rinaldi R, Staffieri C, Marchese-Ragona R, Saia G, Stramare R, et al. Deep neck infection with dental origin: analysis of 85 consecutive cases (2000-2006). Acta Otolaryngol. 2008;128:201-6.
Yang SW, Lee MH, See LC, Huang SH, Chen TM, Chen TA. Deep neck abscess: an analysis of microbial etiology and the effectiveness of antibiotics. Infect Drug Resist. 2008; 1:1-8.
Santos Gorjón P, Blanco Pérez P, Morales Martín AC, Del Pozo de Dios JC, Estévez Alonso S, Calle de la Cabanillas MI. Deep neck infection. Review of 286 cases. Acta Otorrinolaringol Esp. 2012;63:31-41.
Zamiri B, Hashemi SB, Hashemi SH, Rafiee Z, Ehsani S. Prevalence of odontogenic deep head and neck spaces infection and its correlation with length of hospital stay. Shiraz Univ Dent J. 2012;13:29-35.
Chang GH, Tsai MS, Liu CY, Lin MH, Tsai YT, Hsu CM, et al. End-stage renal disease: a risk factor of deep neck infection-a nationwide follow-up study in Taiwan. BMC infect Dis. 2017;17:1-9.
Chaowagul W, Whit NJ, Dance DA, Wattanagoon Y, Naigowit P, Davis TM, et al. Melioidosis: a major cause of community-acquired septicemia in northeastern Thailand. J Infect Dis. 1989;159:890-9.
Srirompotong S, Reechaipichitkul W. Disseminated septicaemic melioidosis: an unusual presentation of masticator space infection. J Laryngol Otol. 2003;117:417-8.
Elango S, Sivakumaran S, Path MRC. Parapharyngeal space melioidosis in a diabetic. J Laryngol Otol. 1991;105:582-3.
Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA. 2016;315:801-10