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https://hdl.handle.net/20.500.14094/0100477985
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2024-06-07
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0100477985 (fulltext)
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メタデータID
0100477985
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open access
出版タイプ
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タイトル
Hematologic and inflammatory parameters for determining severity of odontogenic infections at admission: a retrospective study
著者
Kusumoto, Junya ; Iwata, Eiji ; Huang, Wensu ; Takata, Naoki ; Tachibana, Akira ; Akashi, Masaya
著者ID
A2832
研究者ID
1000000870205
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=594ee1f31af889e2520e17560c007669
著者名
Kusumoto, Junya
楠元, 順哉
クスモト, ジュンヤ
所属機関名
医学部附属病院
著者名
Iwata, Eiji
著者名
Huang, Wensu
著者名
Takata, Naoki
著者名
Tachibana, Akira
著者ID
A1492
研究者ID
1000040597168
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=b7649a2950dc725a520e17560c007669
著者名
Akashi, Masaya
明石, 昌也
アカシ, マサヤ
所属機関名
医学研究科
収録物名
BMC Infectious Diseases
巻(号)
22(1)
ページ
931
出版者
BMC
刊行日
2022-12-12
公開日
2023-01-06
抄録
Background Severe odontogenic infections in the head and neck region, especially necrotizing soft tissue infection (NSTI) and deep neck abscess, are potentially fatal due to their delayed diagnosis and treatment. Clinically, it is often difficult to distinguish NSTI and deep neck abscess in its early stage from cellulitis, and the decision to perform contrast-enhanced computed tomography imaging for detection is often a challenge. This retrospective case–control study aimed to examine the utility of routine blood tests as an adjunctive diagnostic tool for NSTI in the head and neck region and deep neck abscesses. Methods Patients with severe odontogenic infections in the head and neck region that required hospitalization were classified into four groups. At admission, hematologic and inflammatory parameters were calculated according to the blood test results. In addition, a decision tree analysis was performed to detect NSTI and deep neck abscesses. Results There were 271 patients, 45.4% in Group I (cellulitis), 22.5% in Group II (cellulitis with shallow abscess formation), 27.3% in Group III (deep neck abscess), and 4.8% in Group IV (NSTI). All hematologic and inflammatory parameters were higher in Groups III and IV. The Laboratory Risk Indicator for Necrotizing Fasciitis score, with a cut-off value of 6 and C-reactive protein (CRP) + the neutrophil-to-lymphocyte ratio (NLR), with a cut-off of 27, were remarkably useful for the exclusion diagnosis for Group IV. The decision tree analysis showed that the systemic immune-inflammation index (SII) of ≥ 282 or < 282 but with a CRP + NLR of ≥ 25 suggests Group III + IV and the classification accuracy was 89.3%. Conclusions Hematologic and inflammatory parameters calculated using routine blood tests can be helpful as an adjunctive diagnostic tool in the early diagnosis of potentially fatal odontogenic infections. An SII of ≥ 282 or < 282 but with a CRP + NLR of ≥ 25 can be useful in the decision-making for performing contrast-enhanced computed tomography imaging.
キーワード
Cellulitis
Contrast-enhanced computed tomography
Deep neck abscess
Necrotizing soft tissue infection
Neutrophil-to-lymphocyte ratio
Systemic immune-inflammation index
カテゴリ
医学研究科
医学部附属病院
学術雑誌論文
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© The Author(s) 2022.
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
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資源タイプ
journal article
言語
English (英語)
eISSN
1471-2334
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関連情報
DOI
https://doi.org/10.1186/s12879-022-07934-x
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