Universität zu Köln

Riekert, Maximilian, Kreppel, Matthias, Zoeller, Joachim E., Zirk, Matthias, Annecke, Thorsten ORCID: 0000-0002-2496-4432 and Schick, Volker C. (2019). Severe odontogenic deep neck space infections: risk factors for difficult airways and ICU admissions. Oral Maxillofac. Surg.-Heidelb., 23 (3). S. 331 - 337. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1865-1569

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Abstract

Purpose The purpose of this retrospective study was to evaluate perioperative risk factors concerning difficult airway management, primary tracheostomy, and need for intensive care unit (ICU) admission in severe odontogenic space infections. Methods Perioperative risk factors were retrospectively analyzed in 499 cases. Fisher's exact test and analysis of variance were performed to analyze associations between categorical and continuous variables. Univariate regression analysis was used for estimating predictors for ICU admission. A risk model for ICU admission was performed using multivariate regression analysis. Area-under-the-curve (AUC) was calculated by receiver-operating-characteristic (ROC) curve. Results Airway securing in patients with restricted mouth opening led to significant use of the video laryngoscope (p < 0.001) or fiberoptic bronchoscope (p < 0.001). The use of fiberoptic bronchoscopy was significantly increased in patients with dysphagia (p = 0.005) and dyspnea (p = 0.04). Four patients (0.8%) needed primary tracheostomy. ICU admission was significantly associated with higher levels of C-reactive protein (CRP, p = 2.78 x 10(-5)), white blood cell count (WBC, p = 0.003), dyspnea (p = 9.95 x 10(-6)), and higher body mass index (BMI, p = 0.0003). American Society of Anesthesiologists physical status (ASA PS) class III patients (p = 0.04) and the need for the use of a video laryngoscopy (p = 0.003) or fiberoptic bronchoscopy (p = 6.58 x 10(-5)) resulted in a more frequent ICU admission. The AUC of the model was 0.897. Conclusion Difficult airway management was mainly dependent on limited mouth opening and elevated CRP. Elevated CRP, BMI, ASA PS III, and dyspnea were important risk factors for ICU admission. These predictors should be considered preoperatively for proper planning and preparation.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Riekert, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Kreppel, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Zoeller, Joachim E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zirk, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Annecke, Thorsten UNSPECIFIED orcid.org/0000-0002-2496-4432 UNSPECIFIED Schick, Volker C. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-143578
DOI:	10.1007/s10006-019-00770-5
Journal or Publication Title:	Oral Maxillofac. Surg.-Heidelb.
Volume:	23
Number:	3
Page Range:	S. 331 - 337
Date:	2019
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1865-1569
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MANAGEMENT; DIAGNOSIS; ORIGIN Multiple languages Dentistry, Oral Surgery & Medicine Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14357