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Korean J Crit Care Med > Volume 23(2); 2008 > Article
Korean Journal of Critical Care Medicine 2008;23(2): 96-101. doi: https://doi.org/10.4266/kjccm.2008.23.2.96
일개 응급센터를 통해 중환자실로 입원한 급성 심부 경부 감염 환자들의 임상 양상
김진주ㆍ현성열*ㆍ김정권ㆍ임용수ㆍ신종환†ㆍ조진성‡ㆍ류지호§ㆍ이근
가천의과학대학교 길병원 응급의학교실, *흉부외과학교실, †서울시립 보라매병원 응급의학과, ‡동국대병원 응급의학과, §부산대병원 응급의학과
The Clinical Features of Patients with Deep Neck Infections Who Were Admitted to the Intensive Care Unit in a Single Emergency Center
Jin Joo Kim, Sung Youl Hyun, Jung Kwon Kim, Yong Su Lim, Jong Hwan Shin, Jin Seong Cho, Ji Ho Ryu, Gun Lee
1Department of Emergency Medicine, Gachon University Gil Hospital, Incheon, Korea.
2Department of Cardiovascular Surgery, Gachon University Gil Hospital, Incheon, Korea. sungyoul@gilhospital.com
3Department of Emergency Medicine, Seoul Metropolitan Boramae Hospital, Seoul, Korea.
4Department of Emergency Medicine, Dongguk University Hospital, Goyang, Korea.
5Department of Emergency Medicine, Pusan National University Hospital, Busan, Korea.
ABSTRACT
BACKGROUND: Deep neck infections are a life-threatening disease that spread to the neck spaces and the mediastinum via neck fascial planes. In spite of using antibiotics, the mortality of deep neck infections is still high. The aim of our study was to analyze the factors related to mortality and morbidity of patients with deep neck infection who were admitted to the intensive care unit. METHODS: This is a retrospective study of patients with deep neck infections who were admitted to the intensive care unit over a 2 year period between June 2006 and May 2008. The various factors related to mortality and morbidity were analyzed. RESULTS: Twenty-four patients were included over 2 years. The median age was 58 years. Eighteen patients (75%) were males and six patients were females. Ten patients (41.7%) had underlying diabetes mellitus. The median white blood cell count and C-reactive protein (CRP) were 14,000/mm3 and 24.1 mg/dl, respectively. The most common cause of deep neck infection was of dental origin (62.5%) and the most common complication was mediastinitis (37.5%). The factors related to mortality were underlying diabetes mellitus, pO2, CRP, sequential organ failure assessment (SOFA) score, gas-forming score (GAS), and complications due to mediastinitis. CONCLUSIONS: It is useful to measure several factors in patients with deep neck infections. The patients with underlying diabetes mellitus, increased CRP, a GAS score of 2, and complications to mediastinitis have a high mortality rate, so active surgical and medical management should be performed.
Key Words: retropharyngeal abscess; infection; intensive care units
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