A clinical prediction score to determine surgical drainage of deep neck infection: A retrospective case-control study

Int J Surg. 2018 Apr:52:131-135. doi: 10.1016/j.ijsu.2018.02.024. Epub 2018 Feb 15.

Abstract

Background: The objective of this retrospective study was to identify predictors of an abscess guaranteed to be surgically drained successfully in patients with deep neck infection (DNI).

Materials and methods: We divided 97 consecutive patients with DNI into a drained group and a non-drained group. We then developed a clinical prediction score and validated it in 32 further patients.

Results: Significant predictors of successful surgical drainage (i.e., positive for pus) were rim enhancement on computed tomography, C-reactive protein, erythrocyte sedimentation rate, and the neutrophil to lymphocyte ratio. The estimated cut-off values (excluding rim enhancement, which is a yes/no parameter) were 41.25, 56.5, and 8.02, respectively, and the clinical prediction score for each of the four other factors was determined to be 2, 2, 3, and 3 points, respectively. The cut-off score for the sum of these points was 6.5 and the scoring system had an accuracy of 87.5% in the validation group.

Conclusion: Our clinical prediction scoring system can predict whether drainage is successful in patients with DNI.

Keywords: Abscess; Cellulitis; Deep neck infection; Drainage; Prediction score.

Publication types

  • Validation Study

MeSH terms

  • Abscess / surgery*
  • Adult
  • Blood Sedimentation
  • C-Reactive Protein / analysis
  • Case-Control Studies
  • Drainage / methods*
  • Female
  • Humans
  • Leukocyte Count / methods
  • Logistic Models
  • Male
  • Middle Aged
  • Neck / pathology
  • Neck / surgery*
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods

Substances

  • C-Reactive Protein