Fatores preditivos de letalidade e complicações das infecções dos espaços fasciais profundos do pescoço
| Autor: | Marcelo Benedito Menezes, AndrÉ Afonso Nimitz Rodrigues, Norberto Kodi Kavabata, Antonio José Gonçalves, Julia Nascimento Kawamukai, Alexandre Baba Suehara, Evelyn De Almeida Ramos |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty RD1-811 Fasciíte Necrosante Pescoço Infections medicine Humans Fasciitis Necrotizing Mortality Fascia Fasciitis Empyema Pleural Retrospective Studies Septic shock business.industry Pleural empyema Retrospective cohort study Middle Aged medicine.disease Mediastinitis Empyema Surgery Mediastinite Pneumonia Necrotizing Fasciitis Mortalidade Complication business Infection Neck Infecção |
| Zdroj: | Revista do Colégio Brasileiro de Cirurgiões, Volume: 47, Article number: e20202524, Published: 04 SEP 2020 Revista do Colégio Brasileiro de Cirurgiões v.47 2020 Revista do Colégio Brasileiro de Cirurgiões Colégio Brasileiro de Cirurgiões (CBC) instacron:CBC Revista do Colégio Brasileiro de Cirurgiões, Vol 47 (2020) |
| ISSN: | 1809-4546 |
| Popis: | Objective: to identify predictive factors for lethality and complications of deep fascial space infections of the neck (DFSIN), establishing an early and aggressive treatment in the neck before the progression to descending mediastinitis. Methods: we retrospectively analyzed 133 cases of DFSIN treated at Discipline of Head and Neck Surgery of the Medicine School of Santa Casa de Misericórdia de São Paulo. We accessed demographic characteristics, associated diseases, clinical presentation, laboratorial tests, length of hospital stay, number of involved anatomic neck spaces, intra-operative and microbiology findings. We analyzed these data using logistic regression to predict DFSIN lethality and life threatening complications (mediastinitis, septic shock, pneumonia, pleural empyema, skin necrosis). Results: lethality and complication ratios were 9% and 50.3%, respectively. The logistic regression model showed that patients with septic shock were more likely to have progression to death (p < 0.001) and, the presence of more than two involved neck spaces (p < 0.001) and older individuals (p = 0.017) were more likely to have complicated deep neck infections. Descending necrotizing mediatinitis increased the lethality ratio by 50%, and was associated to necrotizing fasciitis (p=0.012) and pleural empyema (p |
| Databáze: | OpenAIRE |
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