Risk Factors of Mortality and Clinical Characteristics in Descending Necrotizing Mediastinitis: A Retrospective Evaluation of 181 Patients.

Abstract

Objectives: Descending necrotizing mediastinitis (DNM) is a serious infection with a high-mortality rate. However, large-scale studies analyzing the clinical characteristics and risk factors of mortality in DNM are rare. This study aimed to clarify the risk factors and some clinical characteristics of mortality of DNM in our hospital. Methods: We retrospectively analyzed the data, including clinical characteristics and mortality, of 181 patients diagnosed with DNM between 2008 and 2022 to clarify the mortality-related risk factors. Results: A total of 181 patients were evaluated, and the mortality rate was 21.55% (39/181 patients). Endo classification type IIB; advanced age; higher white blood cell count, neutrophil percentage, C-reactive protein (CRP) level on admission; and the incidence of septic shock, sepsis, hypoalbuminemia, and electrolyte disorders were significantly related to mortality. Logistic analysis showed that age (≥55 years old), Endo classification type IIB on computed tomography (CT), septic shock, and high CRP level on admission were independent risk factors of mortality. Conclusion: Old age and high CRP levels on admission increase the risk of mortality in DNM patients. Further, Endo classification type IIB on CT and septic shock were associated with poor prognosis.