Hurley R H, Douglas C M, Montgomery J, Clark L J
NHS Greater Glasgow and Clyde , UK.
Ann R Coll Surg Engl. 2018 Feb;100(2):129-134. doi: 10.1308/rcsann.2017.0193. Epub 2017 Oct 19.
Introduction The incidence of deep neck space infection (DNSI) is rising and appears to be related to falling rates of tonsillectomy. The purpose of this study was to assess demographics of patients presenting with DNSI and the financial burden to the National Health Service (NHS). Methods Data were collected retrospectively on patients aged over 16 years admitted to NHS Greater Glasgow and Clyde with DNSI between 2012 and 2016. Demographics, aetiology and use of hospital resources were reviewed. The cost of hospital admissions was calculated using data from NHS Scotland's Information Services Division, the local diagnostics division and the British National Formulary. Results Seventy-four patients were admitted with DNSI during the study period. Forty (54%) were male. The mean age was 44.0 years (range: 16-86 years). The most frequent source of infection was the tonsil (n=30, 40.5%). The most common infective organism was Streptococcus constellatus (n=9, 12.2%). The mean length of stay was 11 days. Fifty-five patients (74.3%) required operative intervention. The mean cost of admission per patient was £5,700 (range: £332-£46,700). Conclusions This study highlights the high cost burden of DNSI to the NHS. The incidence of DNSI in Glasgow has risen over the study period; contributing factors may include the reduced tonsillectomy rate and a reduction in antibiotic prescribing. As the incidence of DNSI continues to rise, there will be an increase in cost to the NHS, which must be planned for.
引言 深部颈部间隙感染（DNSI）的发病率正在上升，且似乎与扁桃体切除术的下降率有关。本研究的目的是评估出现深部颈部间隙感染患者的人口统计学特征以及对国民医疗服务体系（NHS）造成的经济负担。方法 回顾性收集2012年至2016年间因深部颈部间隙感染入住NHS大格拉斯哥和克莱德地区的16岁以上患者的数据。对人口统计学特征、病因及医院资源使用情况进行了审查。利用NHS苏格兰信息服务部、当地诊断部门和英国国家处方集的数据计算住院费用。结果 在研究期间，有74例患者因深部颈部间隙感染入院。40例（54%）为男性。平均年龄为44.0岁（范围：16 - 86岁）。最常见的感染源是扁桃体（n = 30，40.5%）。最常见的感染病原体是星座链球菌（n = 9，12.2%）。平均住院时间为11天。55例患者（74.3%）需要手术干预。每位患者的平均住院费用为5700英镑（范围：332英镑至46700英镑）。结论 本研究突出了深部颈部间隙感染给国民医疗服务体系带来的高昂成本负担。在研究期间，格拉斯哥深部颈部间隙感染的发病率有所上升；促成因素可能包括扁桃体切除率降低和抗生素处方量减少。随着深部颈部间隙感染发病率持续上升，国民医疗服务体系的成本将会增加，对此必须做好规划。
