Identification of risk factors for mortality and delayed oral dietary intake in patients with open drainage due to deep neck infections: Nationwide study using a Japanese inpatient database

Head Neck. 2021 Jul;43(7):2002-2012. doi: 10.1002/hed.26660. Epub 2021 Mar 2.

Abstract

Backgrounds: Data on risk factors for deep neck infection including descending necrotizing mediastinitis (DNM) have been limited. Using a nationwide database, the aim was identifying the factors related to patient death and delay in recovering oral intake.

Methods: Data of 4949 patients were extracted from a Japanese inpatient database between 2012 and 2017. The main outcome was survival at discharge. In a subgroup analysis of the 4949 patients with survival, the second outcome was delay in the interval between admission and full recovery of oral intake.

Results: Only a few factors (advanced-age, ventilation) were associated with both mortality and delayed oral dietary intake by logistic regression analyses. Conversely, several factors including DNM (adjusted-odds ratio [OR] 1.41) and repeated surgery (adjusted-OR 1.70) were significantly related only to delayed oral dietary intake.

Conclusions: Although DNM was not necessarily related to mortality, patients with DNM should receive careful attention to avoid delayed oral dietary intake.

Keywords: DPC database; abscess; deep neck infection; descending necrotizing mediastinitis; logistic regression analysis; mortality; odds ratio; oral intake.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Drainage
  • Eating
  • Humans
  • Inpatients*
  • Japan / epidemiology
  • Mediastinitis*
  • Necrosis
  • Risk Factors