Liver Cirrhosis Predisposes One to Complicated Deep Neck Infection: Retrospective Analysis of 161 Cases.

Abstract

Without appropriate and prompt diagnosis and treatment, life-threatening complications may occur in patients with deep neck infection. Liver cirrhosis occurs more common in Asians and few studies mention if it predisposes to complicated deep neck infection. We aimed to identify predisposing factors of complications to reduce morbidity and mortality. A retrospective analysis of 161 patients with deep neck infection at emergency department of Kaohsiung Chang Gung Memorial Hospital between 2010 and 2012 was performed. We also analyzed the differences between patients with complicated and non-complicated deep neck infection. One hundred and twenty-two patients were men (75.8%). The most common past medical history was diabetes mellitus, followed by liver cirrhosis, which occurs more commonly in Asians. The most common site of involvement was the peritonsillar space (42.9%). The most common pathogen was Streptococcus viridans (23.1%). Fourteen patients (8.7%) had complications and six (3.7%) died during hospitalization. Complicated cases had significantly lower heart rate and mean arterial pressure but higher blood sugar level. They also had higher opportunity to have liver cirrhosis, multiple sites and mediastinum involvement, resulting in longer duration of hospitalization and higher mortality rate. Logistic regression analysis determined that liver cirrhosis was the only predisposing factor for life-threatening complications. People with liver cirrhosis have higher occurrence of complication if they suffered from deep neck infection. Adequate treatment including airway maintenance, appropriate antibiotics, intravenous fluid support and surgical intervention should be provided as soon as possible to decrease complications and mortality.