Are panels of clinical, laboratory, radiological, and microbiological variables of prognostic value in deep neck infections? An analysis of 301 consecutive cases.
Adult
Aged
Analysis of Variance
Anti-Bacterial Agents
/ therapeutic use
Bacterial Infections
/ diagnostic imaging
Cohort Studies
Combined Modality Therapy
Debridement
/ methods
Female
Hospitalization
/ statistics & numerical data
Humans
Male
Middle Aged
Neck
/ pathology
Prognosis
Retrospective Studies
Risk Assessment
Severity of Illness Index
Soft Tissue Infections
/ diagnostic imaging
Statistics, Nonparametric
Survival Rate
Treatment Outcome
Deep neck infections
complications
long-term hospitalization
multivariate analysis
panel
prognosis
Journal
Acta oto-laryngologica
ISSN: 1651-2251
Titre abrégé: Acta Otolaryngol
Pays: England
ID NLM: 0370354
Informations de publication
Date de publication:
Feb 2019
Feb 2019
Historique:
entrez:
20
3
2019
pubmed:
20
3
2019
medline:
14
8
2019
Statut:
ppublish
Résumé
Deep neck infections (DNIs) are often clinically challenging, and may be life-threatening. The present retrospective study aimed to identify panels of clinical, laboratory, radiological, and microbiological parameters that could identify patients with DNIs at higher risk of complications or long-term hospitalization. The investigation concerned 301 consecutive patients with DNIs treated at our institution between 2000 and 2014. The discriminatory power of a combination of two variables (unknown origin of the infection and the need for surgical treatment) in terms of deep neck infection complications occurrence featured an AUC (ROC) of 0.6701. The power of a panel of four variables (age, leukocyte count, need for surgical treatment, days elapsing from hospitalization to surgical procedure) to identify DNIs necessitating long-term hospitalization featured an AUC (ROC) of 0.7929. Using the scale proposed by Hosmer and Lemeshow, the four-variable panel showed an amply acceptable, nearly excellent discriminatory power for long-term hospitalization. Although this panel achieved promising results for prognostic purposes, other parameters potentially capable of predicting the outcome of DNIs and orienting treatment decisions need to be investigated.
Sections du résumé
BACKGROUND
BACKGROUND
Deep neck infections (DNIs) are often clinically challenging, and may be life-threatening.
OBJECTIVE
OBJECTIVE
The present retrospective study aimed to identify panels of clinical, laboratory, radiological, and microbiological parameters that could identify patients with DNIs at higher risk of complications or long-term hospitalization.
MATERIALS AND METHODS
METHODS
The investigation concerned 301 consecutive patients with DNIs treated at our institution between 2000 and 2014.
RESULTS
RESULTS
The discriminatory power of a combination of two variables (unknown origin of the infection and the need for surgical treatment) in terms of deep neck infection complications occurrence featured an AUC (ROC) of 0.6701. The power of a panel of four variables (age, leukocyte count, need for surgical treatment, days elapsing from hospitalization to surgical procedure) to identify DNIs necessitating long-term hospitalization featured an AUC (ROC) of 0.7929.
CONCLUSION
CONCLUSIONS
Using the scale proposed by Hosmer and Lemeshow, the four-variable panel showed an amply acceptable, nearly excellent discriminatory power for long-term hospitalization.
SIGNIFICANCE
CONCLUSIONS
Although this panel achieved promising results for prognostic purposes, other parameters potentially capable of predicting the outcome of DNIs and orienting treatment decisions need to be investigated.
Identifiants
pubmed: 30887898
doi: 10.1080/00016489.2018.1532606
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Langues
eng