1. Sequential Impact of Diabetes Mellitus on Deep Neck Infections: Comparison of the Clinical Characteristics of Patients with and without Diabetes Mellitus.
- Author
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Liao, Ting-I, Ho, Chia-Ying, Chin, Shy-Chyi, Wang, Yu-Chien, Chan, Kai-Chieh, and Chen, Shih-Lung
- Subjects
ANTIBIOTICS ,DIABETES complications ,NECK ,SOFT tissue infections ,RISK assessment ,ACADEMIC medical centers ,COMPUTED tomography ,LOGISTIC regression analysis ,BLOOD cell count ,SEVERITY of illness index ,EVALUATION of medical care ,RETROSPECTIVE studies ,CHI-squared test ,MANN Whitney U Test ,MULTIVARIATE analysis ,DESCRIPTIVE statistics ,ODDS ratio ,KLEBSIELLA infections ,METRONIDAZOLE ,STATISTICS ,COMPARATIVE studies ,LENGTH of stay in hospitals ,CONFIDENCE intervals ,DATA analysis software ,STREPTOCOCCAL diseases ,C-reactive protein ,CEFTRIAXONE ,NONPARAMETRIC statistics ,PARVOVIRUS diseases ,DISEASE risk factors ,DISEASE complications ,SYMPTOMS - Abstract
Background: Deep neck infections (DNIs) can compromise the airway and are associated with high morbidity and mortality rates. Diabetes mellitus (DM) is a metabolic disorder characterized by chronic hyperglycemia that is associated with several comorbidities. We compared the clinical characteristics of DNI patients with and without DM. Methods: This study recorded the relevant clinical variables of 383 patients with DNIs between November 2016 and September 2022; of those patients, 147 (38.38%) had DM. The clinical factors between DNI patients with and without DM were assessed. Results: Patients with DM were older (p < 0.001), had higher white blood cell counts (p = 0.029) and C-reactive protein levels (CRP, p < 0.001), had a greater number of deep neck spaces (p = 0.002) compared to patients without DM, and had longer hospital stays (p < 0.001). Klebsiella pneumoniae was cultured more frequently from patients with DM than those without DM (p = 0.002). A higher CRP level (OR = 1.0094, 95% CI: 1.0047–1.0142, p < 0.001) was a significant independent risk factor for DM patients with prolonged hospitalization. The lengths of hospital stays in patients with poorly controlled DM were longer than those with well-controlled DM (p = 0.027). Conclusions: DNI disease severity and outcomes were worse in patients with DM than those without DM. Antibiotics effective against Klebsiella pneumoniae should be used for DNI patients with DM. DNI patients with DM and high CRP levels had more prolonged hospitalizations. Appropriate blood glucose control is essential for DNI patients with DM. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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