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Risk factors for deep neck infection in patients with sore throat and neck pain

BACKGROUND: Deep neck infection (DNI) is a potentially life-threatening disease because infections spread quickly, causing serious complications. Therefore, more attention is needed than other neck infections, but there are many difficulties due to isolation guidelines in the period of coronavirus d...

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Autores principales: In Hong, Seong, Hoon Lee, Dong, Chung, Ho Sub, Hee Choi, Yoon, Jin Bae, Sung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kare Publishing 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10315931/
https://www.ncbi.nlm.nih.gov/pubmed/37278070
http://dx.doi.org/10.14744/tjtes.2023.28608
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author In Hong, Seong
Hoon Lee, Dong
Chung, Ho Sub
Hee Choi, Yoon
Jin Bae, Sung
author_facet In Hong, Seong
Hoon Lee, Dong
Chung, Ho Sub
Hee Choi, Yoon
Jin Bae, Sung
author_sort In Hong, Seong
collection PubMed
description BACKGROUND: Deep neck infection (DNI) is a potentially life-threatening disease because infections spread quickly, causing serious complications. Therefore, more attention is needed than other neck infections, but there are many difficulties due to isolation guidelines in the period of coronavirus disease 2019 pandemic. We investigated the early predictability of DNI through patient symptoms at the first emergency department encounter. METHODS: This was a retrospective study of patients with suspected soft-tissue neck infections from January 2016 to February 2021. Symptoms were retrospectively analyzed in fever, foreign body sensation, chest discomfort/pain, submandibular pain, odynophagia, dysphagia, voice change, and severe pain. Furthermore, baseline characteristic data, laboratory findings, and pre-vertebral soft-tissue (PVST) thickness were evaluated. DNI and other neck infections were diagnosed through computed tomography. Logistic regression analysis was conducted to determine the independent factors for predicting DNI. RESULTS: In the 793 patients included in the study, 267 (33.7%) were diagnosed with DNI, and 526 (66.3%) were diagnosed with other soft-tissue neck infections. In the comparison between the two groups, C-reactive protein (CRP), sodium, PT (INR), foreign body sensation, chest discomfort/pain, submandibular pain, odynophagia, dysphagia, severe pain, and PVST thickness showed statistically significant differences. Independent factors for predicting DNI were severe pain (odds ratio: 6.336 [3.635–11.045], p<0.001), foreign body sensation (odds ratio: 7.384 [2.776–19.642], p<0.001), submandibular pain (odds ratio: 4.447 [2.852–6.932], p<0.001), and dysphagia (odds ratio: 52.118 [8.662–313.588], p<0.001) among symptoms and CRP (odds ratio: 1.034 [1.004–1.065], p=0.026) and PT (INR) (odds ratio: 29.660 [3.363–261.598], p=0.002) in laboratory tests. PVST thickness at C2 (odds ratio: 1.953 [1.609–2.370], p<0.001) and C6 level (odds ratio: 1.179 [1.054–1.319], p=0.004) was also shown as an independent variable for prediction. CONCLUSION: Among patients with sore throat or neck pain, patients with dysphagia, foreign body sensation, severe pain, and submandibular pain are more likely to have DN. DNI can cause serious complications; therefore, patients with the above symptoms should be closely observed due to the potential for significant complications.
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spelling pubmed-103159312023-07-04 Risk factors for deep neck infection in patients with sore throat and neck pain In Hong, Seong Hoon Lee, Dong Chung, Ho Sub Hee Choi, Yoon Jin Bae, Sung Ulus Travma Acil Cerrahi Derg Original Article BACKGROUND: Deep neck infection (DNI) is a potentially life-threatening disease because infections spread quickly, causing serious complications. Therefore, more attention is needed than other neck infections, but there are many difficulties due to isolation guidelines in the period of coronavirus disease 2019 pandemic. We investigated the early predictability of DNI through patient symptoms at the first emergency department encounter. METHODS: This was a retrospective study of patients with suspected soft-tissue neck infections from January 2016 to February 2021. Symptoms were retrospectively analyzed in fever, foreign body sensation, chest discomfort/pain, submandibular pain, odynophagia, dysphagia, voice change, and severe pain. Furthermore, baseline characteristic data, laboratory findings, and pre-vertebral soft-tissue (PVST) thickness were evaluated. DNI and other neck infections were diagnosed through computed tomography. Logistic regression analysis was conducted to determine the independent factors for predicting DNI. RESULTS: In the 793 patients included in the study, 267 (33.7%) were diagnosed with DNI, and 526 (66.3%) were diagnosed with other soft-tissue neck infections. In the comparison between the two groups, C-reactive protein (CRP), sodium, PT (INR), foreign body sensation, chest discomfort/pain, submandibular pain, odynophagia, dysphagia, severe pain, and PVST thickness showed statistically significant differences. Independent factors for predicting DNI were severe pain (odds ratio: 6.336 [3.635–11.045], p<0.001), foreign body sensation (odds ratio: 7.384 [2.776–19.642], p<0.001), submandibular pain (odds ratio: 4.447 [2.852–6.932], p<0.001), and dysphagia (odds ratio: 52.118 [8.662–313.588], p<0.001) among symptoms and CRP (odds ratio: 1.034 [1.004–1.065], p=0.026) and PT (INR) (odds ratio: 29.660 [3.363–261.598], p=0.002) in laboratory tests. PVST thickness at C2 (odds ratio: 1.953 [1.609–2.370], p<0.001) and C6 level (odds ratio: 1.179 [1.054–1.319], p=0.004) was also shown as an independent variable for prediction. CONCLUSION: Among patients with sore throat or neck pain, patients with dysphagia, foreign body sensation, severe pain, and submandibular pain are more likely to have DN. DNI can cause serious complications; therefore, patients with the above symptoms should be closely observed due to the potential for significant complications. Kare Publishing 2023-06-05 /pmc/articles/PMC10315931/ /pubmed/37278070 http://dx.doi.org/10.14744/tjtes.2023.28608 Text en Copyright © 2023 Turkish Journal of Trauma and Emergency Surgery https://creativecommons.org/licenses/by-nc/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
spellingShingle Original Article
In Hong, Seong
Hoon Lee, Dong
Chung, Ho Sub
Hee Choi, Yoon
Jin Bae, Sung
Risk factors for deep neck infection in patients with sore throat and neck pain
title Risk factors for deep neck infection in patients with sore throat and neck pain
title_full Risk factors for deep neck infection in patients with sore throat and neck pain
title_fullStr Risk factors for deep neck infection in patients with sore throat and neck pain
title_full_unstemmed Risk factors for deep neck infection in patients with sore throat and neck pain
title_short Risk factors for deep neck infection in patients with sore throat and neck pain
title_sort risk factors for deep neck infection in patients with sore throat and neck pain
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10315931/
https://www.ncbi.nlm.nih.gov/pubmed/37278070
http://dx.doi.org/10.14744/tjtes.2023.28608
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