2018-19 Section 7-Neoplastic and Inflammatory Diseases of the Head and Neck eBook

TABLE I. Study Demographics and Comorbidity Characteristics.

Pediatrics

Adults

0 days

1–2 days

3–7 days

0 days

1–2 days

3–7 days

n (%)

n (%)

n (%)

n (%)

n (%)

n (%)

(n 5 282)

(n 5 299)

(n 5 84)

(n 5 191)

(n 5 104)

(n 5 52)

Variable

Age, years, mean (SD)

4.5 (4.4)

4.1 (3.8)

4.5 (4.0)

44.7 (14.8)

46.8 (17.6)

47.6 (16.4)

Gender, number male

161 (57.1)

169 (56.5)

51 (60.7)

116 (60.7)

69 (66.3)

31 (59.6)

Race

54 (64.3) a

White

146 (51.8)

179 (59.9)

113 (59.2)

56 (53.8) 16 (15.4)

30 (57.7)

African American

45 (16.0)

42 (14.0)

16 (19.0)

27 (14.1)

6 (11.5)

Hispanic

46 (16.3)

52 (17.4)

6 (7.1)

13 (6.8)

11 (10.6)

< 5* < 5*

Asian or Pacific Islander

14 (5.0)

5 (1.7)

< 5*

13 (6.8)

< 5*

Other/unknown

31 (11.0)

21 (7.0)

7 (8.3)

25 (13.1)

17 (16.3)

9 (17.3)

BMI, mean, SD

18.26 (5.7)

17.57 (4.6)

16.92 (3.7)

29.3 (8.5)

29.2 (8.2)

27.6 (7.0)

Medical comorbidities DM

13 (25.0) a

0 (0)

0 (0)

< 5* < 5* 0 (0)

27 (14.1)

29 (27.9)

Asthma

13 (4.6)

7 (2.3)

NA

NA

NA

Bleeding disorder

< 5*

< 5*

7 (3.7)

5 (4.8) 8 (7.7)

< 5*

< 5* ,a

Steroid use for chronic condition

18 (6.4)

17 (5.7)

5 (6.0)

< 5*

Congenital heart disease

< 5*

< 5*

0 (0)

NA

NA

NA

HTN requiring medication

NA

NA

NA

66 (34.6)

38 (36.5)

20 (38.5)

Surgery variables

ASA classification 1

0 (0) a

106 (37.6) 147 (52.1)

88 (29.4)

28 (33.3) 49 (58.3)

18 (9.4)

7 (6.7)

2

174 (58.2)

91 (47.6)

41 (39.4)

16 (30.8)

3

26 (9.2)

35 (11.7)

5 (6.0)

67 (35.1)

46 (44.2)

30 (57.7)

4 or 5

7 (1.1)

< 5*

< 5*

13 (6.9)

10 (9.6)

6 (11.5)

Surgical approach External

160 (56.7)

168 (56.2)

37 (44.0)

160 (83.8)

92 (88.5)

45 (86.5)

Intraoral

122 (43.3)

131 (43.8)

47 (56.0)

31 (16.2)

12 (11.5)

7 (13.5)

Infectious variables

Preoperative sepsis None

38 (45.2) a

25 (48.1) a

112 (58.6)

55 (55.9) 13 (12.5)

149 (52.8)

129 (43.1)

SIRS

12 (4.3)

19 (6.4)

6 (7.1)

21 (11.0)

< 5*

Sepsis

120 (42.6)

150 (50.2)

37 (44.0)

55 (28.8)

34 (32.7)

23 (44.3)

Septic shock

< 5*

< 5*

< 5*

< 5*

< 5*

0 (0)

White blood cell count Mean in 1000 cells/ l

L, SD

19.3 (7.3)

19.1 (7.5)

16.6 (6.4)

13.8 (5.9)

12.9 (6.9)

12.2 (5.0)

ICD-9 postoperative diagnosis Parapharyngeal abscess (478.22)

52 (18.4)

45 (15.1)

15 (17.9)

27 (14.1)

5 (4.8)

< 5*

Retropharyngeal abscess (478.24)

86 (30.5)

94 (31.4)

35 (41.7)

17 (8.9)

11 (10.6)

7 (13.5)

Other deep neck abscess (682.1)

144 (51.1)

160 (53.5)

34 (40.5)

147 (77.0)

88 (84.6)

41 (78.8)

Cell size n < 5 are masked with an * to protect patient privacy unless the event was a composite event. (a) indicates p < 0.05. ASA 5 American College of Surgeons; BMI 5 body mass index; COPD 5 chronic obstructive pulmonary disease; DM 5 diabetes mellitus; HTN 5 hypertension; ICD-9 5 International Classification of Diseases, Ninth Revision; NA 5 not applicable; SD 5 standard deviation; SIRS 5 systemic inflammatory response syndrome.

variate regression are shown in Supporting Table SI. On multivariate regression, we identified timing of surgery, female gender, ASA class III through V, preoperative sep- sis or septic shock, and preoperative white blood cell count as significant predictors of postoperative M&M in adults—whereas in pediatrics we identified female gen- der, congenital malformation, ASA class III or IV, and pre- operative sepsis or septic shock as significant predictors

In pediatric patients, there was a significant increase in length of hospital stay for patients undergoing surgical drainage on days 3 to 7 after admission ( P < 0.001). In contrast to adults, there were also no significant differen- ces between groups for abscess-specific and nonspecific complications. Demographic characteristics related to abscess- specific M&M used in the selection of variables for multi-

Laryngoscope 126: August 2016

Cramer et al.: Delay in Drainage of Deep Neck Abscess

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