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J Korean Soc Emerg Med > Volume 19(5); 2008 > Article
Journal of The Korean Society of Emergency Medicine 2008;19(5): 576-581.
Clinical Variables Indicating Cervical Abscess in Adult Patients Diagnosed with Deep Neck Infection
Won Joon Jeong, Hwa yeon Lee, Won Suk Lee, Sang Kyoon Han, In Soo Kim, Seung Ryu, Jin Woong Lee, Seung Whan Kim, In Sool Yoo, Yeon Ho You
1Department of Emergency Medicine, Chungnam National University hospital, Daejeon, Korea. mdinsool@cnuh.co.kr
2Department of Emergency Medicine, College of Medicine, Konyang University, Daejeon, Korea.
ABSTRACT
PURPOSE:
We evaluated a method to distinguish group A (abscess) from group B (cellulitis, pharyngitis, tonsillitis, epiglottis) through clinical variables in patients with a deep neck infection.
METHODS:
This was a retrospective chart review study consisting of the evaluation of CT scans or surgical diagnoses on adult patients (18 or more years of age). CT scans were reviewed by a radiologist. We evaluated several clinical variables in order to distinguish group A from group B. We also evaluated the ability of these clinical variables to distinguish group A from group B by a receiver operating characteristic curve.
RESULTS:
Sixty-three patients were enrolled in this study. Several clinical variables (swelling, odynophagia, tenderness, trismus, age>50years) differed between group A and group B. A AUC which was obtained by adding the number of variables (swelling, odynophagia, tenderness, trismus, age>50years) was 0.87 (p<0.01). The sensitivity and specificity of these clinical variables were 0.96 and 0.6 respectively, when the cut off value for adding the number of variables was set as 1.5. When the sum of these number of variables are more than two, the sensitivity is 0.958 (95% C.I:0.901~0.987) and the specificity is 0.600 (95% C.I:0.417~0.693).
CONCLUSION:
Five clinical variables (age>50, swelling, odynophagia, tenderness, trismus) were able to distinguish group A from group B.
Key words: Neck, Soft tissue infections, Abscess, Risk assessement
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