Staffieri Claudia, Fasanaro Elena, Favaretto Niccolo', La Torre Fabio Biagio, Sanguin Saverio, Giacomelli Luciano, Marino Filippo, Ottaviano Giancarlo, Staffieri Alberto, Marioni Gino
Otolaryngology Section, Department of Neurosciences, Treviso Branch, University of Padova, Padua, Italy.
Eur Arch Otorhinolaryngol. 2014 Jul;271(7):2061-7. doi: 10.1007/s00405-014-2926-5. Epub 2014 Feb 13.
Deep neck infections (DNI) spread along fascial planes and involve neck spaces. Very few studies have investigated potentially prognostic factors using multivariate statistical models. Our aim was to analyze 282 consecutive cases of DNI using multivariate (logistic) statistical models to identify independent significant factors influencing prognosis in terms of complications and long-term hospitalization (>6 days). In our series, only involvement of more than one neck space was independently significant in prognosticating complications of DNI (odds ratio [OR] 2.46). The presence of comorbidities (OR 2.13), non-odontogenic sites of origin (OR 1.88), leukocyte counts above 11.0 cells × 10(9)/L at presentation (OR 3.57), and the need for both medical and surgical treatments (OR 4.66) was significantly and independently prognostic of long hospital stays. Multivariate analysis can distinguish between risk factors and their relative contribution to outcome. The few published studies using multivariate models to analyze DNI prognosis considered quite large cohorts, but no clinical variables persistently revealed an independent significant prognostic role. This evidence seems to underscore the complex interdependence of several clinical variables in contributing to DNI prognosis, and the heterogeneity of the diagnostic/therapeutic approaches adopted.
深部颈部感染（DNI）沿筋膜平面扩散并累及颈部间隙。很少有研究使用多变量统计模型来调查潜在的预后因素。我们的目的是使用多变量（逻辑）统计模型分析282例连续的DNI病例，以确定在并发症和长期住院（>6天）方面影响预后的独立显著因素。在我们的系列研究中，只有累及一个以上颈部间隙在预测DNI并发症方面具有独立显著性（比值比[OR]为2.46）。合并症的存在（OR为2.13）、非牙源性起源部位（OR为1.88）、就诊时白细胞计数高于11.0×10⁹/L（OR为3.57）以及需要药物和手术治疗（OR为4.66）对长期住院具有显著且独立的预后意义。多变量分析可以区分风险因素及其对结果的相对贡献。少数使用多变量模型分析DNI预后的已发表研究考虑了相当大的队列，但没有临床变量持续显示出独立的显著预后作用。这一证据似乎强调了几个临床变量在DNI预后中的复杂相互依存关系，以及所采用的诊断/治疗方法的异质性。
