Multi-Space Infections in the Head and Neck: Do Underlying Systemic Diseases Have a Predictive Role in Life-Threatening Complications?

PURPOSE:To assess the incidence, risk factors, treatment, and outcomes of life-threatening complications of multi-space infections (LCMIs) in the head and neck. PATIENTS AND METHODS:This was a retrospective cohort study that enrolled a sample of patients with multi-space infections who were referred from February 2006 through July 2014. The patients were classified into LCMI and non-LCMI groups. The primary predictor in this study was underlying systemic disease. The primary outcome variable was LCMI. Univariate analyses were used for data statistics. RESULTS:A total of 549 patients were included, and an LCMI was found in 66 patients (12.20%). Descending mediastinitis was the most frequent LCMI (n = 37; 56.06%), followed by airway obstruction (n = 27; 40.91%), pneumonia (n = 12; 18.18%), pericarditis (n = 6; 9.09%), intraorbital infection (n = 2; 3.03%), multiple organ failure (n = 2; 3.03%), intracranial infection (n = 2; 3.03%), and sudden cardiac death (n = 1; 1.52%). Twelve patients with LCMI died during treatment. Elderly patients with an underlying systemic disease more commonly developed an LCMI. CONCLUSIONS:Multi-space infections in the head and neck can cause several life-threatening complications, and the morbidity of LCMI is considerable. Older age and underlying systemic disease can increase the risk of an LCMI.