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. (C) 2015 American Association of Oral and Maxillofacial Surgeons