A Study of Factors that Contribute to the Severe Progression of Peritonsillar Abscess

Abstract

Abstract Background Based on the background factors and results of blood tests in patients with peritonsillar abscess, we investigated the factors involved in the prolongation of hospitalization and progression to deep neck abscess of these patients. Objective and Methods We studied the data of 113 patients with peritonsillar abscesses (including those in whom the condition progressed to deep neck abscesses) who were hospitalized at our department during the 3-year period from August 2014 to August 2017. Data of patients who needed hospitalized treatment for 7 days or more, including the age, body mass index (BMI), sickness period, white blood cell count, serum C-reactive protein (CRP), serum total protein, serum albumin, blood glucose, blood HbA1c, and estimated glomerular filtration rate (eGFR) at the first examination, and the neck factors in the cases that progressed to deep cervical abscess were examined using t-tests. Results The blood test items and background factors at the first visit were compared according to the length of hospitalization. The results revealed that prolonged hospitalization was associated with higher values of age, peripheral blood white blood cell count, serum CRP value and blood glucose, and lower values of serum total protein, serum albumin, and eGFR. Conclusions Factors that were associated with a longer hospital stay in this study were relatively high values of age, peripheral blood white blood cell count, blood glucose and serum CRP, and relatively low values of the serum total protein, serum albumin, and eGFR. The disease duration, BMI, and HbA1c were not identified as significant factors. Stepwise multiple regression analysis to identify factors associated with prolonged hospitalization identified the blood glucose and serum albumin levels measured at the first visit as significant predictors of a prolonged hospital stay and higher severity of the illness. Our findings suggested the importance of measuring these factors for predicting the progression to deep cervical abscess.