Initial Nutritional Status and Clinical Outcomes in Patients With Deep Neck Infection

박만준; 김지원; 김용한; 이윤세; 노종렬; 최승호; 김상윤; 남순열

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자료유형: 학술저널

저자정보: 박만준 김지원 김용한 이윤세 노종렬 최승호 김상윤 남순열

저널정보: 대한이비인후과학회 Clinical and Experimental Otorhinolaryngology Clinical and Experimental Otorhinolaryngology 제11권 제4호

발행연도: 2018.1

수록면: 293 - 300 (8page)

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Objectives. The current study aims to determine the correlation between nutritional status upon presentation and disease severity, as well as treatment and survival outcomes. Methods. Patients who were diagnosed with deep neck infection, underwent at least one surgical drainage/debridement, and had more than 1 week of hospitalization at a tertiary medical center from 2007 to 2015 were retrospectively included. Thereafter, initial serum albumin, C-reactive protein (CRP), and body mass index (BMI) were reviewed. Results. A total of 135 patients were included in the final analysis. Accordingly, the proportion of patients with simultaneous mediastinitis (21.0%), necrotizing fasciitis (12.9%), disease extent >1 cervical level (72.6%), mean CRP (22.4 mg/dL), mean length of hospitalization (25.0 days), and mean 1-week follow-up CRP (7.2 mg/dL) was significantly higher in the hypoalbuminemia group (initial serum albumin <3.0 g/dL) than in the normoalbuminemia group (all P<0.05). No significant correlations had been observed according to BMI status. After adjusting for age and Charlson comorbidity index, odds ratios for the following outcomes were calculated in patients initially presenting with hypoalbuminemia: simultaneous mediastinitis (3.07), necrotizing fasciitis (7.89), disease extent >1 cervical level (2.12), initial serum CRP over 20 mg/dL (3.79), hospitalization of more than 14 days (4.10), 1-week follow-up CRP over 5 mg/dL (3.78), and increased duration for an over 50% decrease in initial CRP (2.70) (all P<0.05). Although intravascular albumin replenishment decreased the proportion of patients with hypoalbuminemia after 2 weeks (P<0.05), it did not significantly predict better treatment outcomes. Conclusion. Among the markers reflecting an individual’s nutritional state, an initial serum albumin of less than 3.0 g/dL was an independent serologic marker predicting increased disease severity and complications in patients with deep neck infection.

참고문헌 (37)

참고문헌 신청

Brito TP / 2017 / Deep neck abscesses: study of 101 cases / Braz J Otorhinolaryngol 83(3):341~348

Vieira F / 2008 / Deep neck infection / Otolaryngol Clin North Am 41(3):459~483

Kataria G / 2015 / Deep neck space infections: a study of 76 cases / Iran J Otorhinolaryngol 27(81):293~299

Mazzella A / 2016 / Descending necrotizing mediastinitis in the elderly patients / Open Med (Wars) 11(1):449~460

문정환 / 2015 / 심경부감염 환자 치료에 있어서 Modified LRINEC 점수의 유용성 / 대한이비인후과학회지 두경부외과학 58(2):115~119

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