Identification of risk factors for mortality and delayed oral dietary intake in patients with open drainage due to deep neck infections: Nationwide study using a Japanese inpatient database

Hidaka, Hiroshi; Tarasawa, Kunio; Fujimori, Kenji; Obara, Taku; Fushimi, Kiyohide; Sakagami, Tomofumi; Yagi, Minoru; Iwai, Hiroshi

doi:10.1002/hed.26660

Cited by 9 publications

(13 citation statements)

References 40 publications

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“…Although it has been reported that resumption of oral intake is delayed in patients with descending necrotizing mediastinitis, there was no significant difference in FOIS for each period between patients with and those without mediastinal abscess in this study [13]. Thoracoscopic or thoracotomy drainage also did not affect FOIS in our study.…”

Section: Discussioncontrasting

confidence: 79%

Postoperative Swallowing Function in Patients with Deep Neck Infection

Ashizawa,

Hisaoka,

Ikeda

et al. 2023

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Introduction: Early detection of dysphagia risk, initiating rehabilitation, and resumption of appropriate diet based on swallowing function is important during deep neck infection (DNI) control. This study aimed to evaluate the extent of cervical abscess development, particularly in the deep neck space, and its relationship to postoperative swallowing function. Methods: A retrospective chart review was performed for all DNI cases treated between April 2015 and April 2021. Deep neck spaces were divided into categories based on computed tomography findings. Functional Oral Intake Scale (FOIS) scores of 4 or higher was defined as normal or slight swallowing disorder and 3 or lower as dysphagia. Results: Seventeen cases were included in the analysis. Based on FOIS, 14 cases were classified into the dysphagia group at 2 weeks after surgery, 11 cases at 4 weeks, and 8 cases at 8 weeks. There was no significant difference between the location of the abscess and dysphagia at 2 weeks after surgery. Patients with anterior cervical space abscess significantly increased dysphagia 4 weeks (p = 0.018) and 8 weeks (p = 0.036) after surgery. Conclusion: Abscess formation in the anterior cervical space may be associated with prolonged dysphagia after treatment due to inflammation and scarring of the muscles associated with swallowing.

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Section: Discussioncontrasting

confidence: 79%

Postoperative Swallowing Function in Patients with Deep Neck Infection

Ashizawa,

Hisaoka,

Ikeda

et al. 2023

Biomed Hub

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“…Multiple logistic regression analysis was performed to compare multiple outcome categories, assessing the independent effect on the severity of intracranial complications. Inclusion of independent variables in the model was based on earlier research and existing knowledge in terms of the following risk factors for aggravation of intracranial complication and abscesses in the head and neck region (2)(3)(4)(5)11,14,21): age, sex, pathogenesis (cholesteatoma or other otitis media), type of complication (subdural abscess including cerebral abscess or other intracranial complications such as epidural abscess or meningitis), level of consciousness evaluated by the JCS, comorbid DM and sepsis, and repeated surgical interventions.…”

Section: Discussionmentioning

confidence: 99%

“…Data were extracted from the Diagnostic Procedure Combination (DPC) database, a national inpatient database in Japan. The details of the DPC database have been described previously (12)(13)(14). Briefly, the DPC database includes administrative claims data and detailed medical data collected for all inpatients discharged from participating hospitals.…”

Section: Data Sourcementioning

confidence: 99%

“…The following background characteristics of the patients were assessed: age; sex; main diagnosis; comorbidities at admission including level of consciousness evaluated by the Japan Coma Scale (JCS), diabetes mellitus (DM; International Classification of Diseases, 10th Revision [ICD-10] codes: E10-E14), and sepsis (ICD-10 codes: A40-A41, D65) classified according to the ICD-10 and test data in Japan (12)(13)(14)(15)(16)(17); number of surgical interventions; length of stay; and discharge status.…”

Section: Patient Selection and Characteristicsmentioning

confidence: 99%

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Identification of Risk Factors for Mortality and Prolonged Hospitalization in Patients Treated With Surgical Drainage for Otogenic Intracranial Complications: A Nationwide Study Using a Japanese Inpatient Database

Hidaka,

Tarasawa,

Fujimori

et al. 2023

Otol Neurotol

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Objective Data on risk factors for otogenic intracranial complications including cerebral abscess have been limited. Using a nationwide database, the aim was to identify the factors related to mortality and delayed discharge. Study Design Retrospective. Setting Nationwide database using the Diagnostic Procedure Combination database. Main Outcome Measures Data of 145 patients were extracted from a Japanese inpatient database between 2012 and 2020. The main outcome was survival at discharge. In a subgroup analysis of the 137 surviving patients, the second outcome was delayed discharge. Results The mortality rate was 5.5% (8 of 145). Logistic regression analyses identified intracerebral complications (adjusted odds ratio [OR], 3.09) and more than 2-day delay of the first surgery after admission (adjusted OR, 4.68) as risk factors for mortality. Specifically, consciousness level evaluated by the Japan Coma Scale (JCS) was significantly related to prolonged hospitalization or mortality: JCS I (adjusted OR, 3.40) and JCS ≥II (adjusted OR, 25.1). Conclusions Although otogenic intracranial complications are rare, and their mortality is decreasing because of the progress in imaging and clinical strategies, they remain the most severe complications of suppurative otitis media and/or cholesteatoma. Consciousness level at admission, comorbid diabetes mellitus, and a greater than 2-day delay of surgical intervention were related to prolonged hospitalization or mortality.

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“…BI at discharge was classified as under 59 and over 60. Age, smoking status, and BI were classified according to previous studies 16–19 . As for LOS, we used it as a continuous variable because there is no standard grouping method for LOS like BI and BMI.…”

Section: Methodsmentioning

confidence: 99%

Risk factors of readmission and the impact of outpatient management in heart failure patients: A national study in Japan

Miyazaki,

Tarasawa,

Fushimi

et al. 2023

ESC Heart Failure

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AimsHeart failure is a significant disease, and its high readmission rate is a big concern. We must identify readmission risk factors and optimize outpatient management to prevent them. This study aims to investigate the readmission risk factors, including outpatient management represented by the number of outpatient visits, and to identify the factors related to frequent outpatient visits.Methods and resultsWe used the diagnosis‐procedure‐combination database between April 2016 and March 2022. Based on the number of outpatient visits within 60 days after discharge, we categorized patients into <1 visits/month, (1<, ≦2) visits/month, and <2 visits/month and observed the occurrence of 60 days readmission. We performed multiple logistic regression analyses to reveal the readmission risk factors and the association between the number of outpatient visits and readmission. As a subgroup analysis, we conducted the same research in the low‐ and high‐readmission risk groups. We compared medical contents between (1<, ≦2) visits/month and <2 visits/month. We analysed 101 239 patients and identified the following factors as a risk of readmission: older age (P < 0.001), female (P = 0.009), longer length‐of‐hospital‐stay (P < 0.001), artificial ventilator (P < 0.001), tolvaptan (P < 0.001), top 50% dosage of loop diuretics (P = 0.036), bottom 50% dosage of class III antiarrhythmic agents (P < 0.001), hypertension (P = 0.005), atrial fibrillation (P < 0.001), dilated cardiomyopathy (P < 0.001), valvular disease (P = 0.021), myocardial infarction (P < 0.001), diabetes (P < 0.001), and renal disease (P < 0.001). We revealed that the risk of readmission increases in <2 visits/month compared to (1<, ≦2) visits/month (P < 0.001), whereas the risk of readmission decreases in ≦1 visits/month compared with (1<, ≦2) visits/month (P < 0.001). In the subgroup analysis, we found the possibility that some risk factors are specific to the subgroup. We identified that the following factors were related to frequent outpatient visits: older age (P < 0.001), home medical care (P = 0.007), tolvaptan (P < 0.001), top 50% dosage of loop diuretics (P < 0.001), diabetes (P < 0.001), renal disease (P = 0.009), 0–2 weeks follow‐up (P < 0.001), 2–4 weeks follow‐up (P < 0.001), cardiac rehabilitation (P < 0.001), and echocardiography (P < 0.001).ConclusionsThis study comprehensively identified risk factors for readmission and found outpatient visit is personalized by readmission risk. There is still room to optimize outpatient management. We suggest optimizing outpatient management according to our identified characteristics.

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Identification of risk factors for mortality and delayed oral dietary intake in patients with open drainage due to deep neck infections: Nationwide study using a Japanese inpatient database

Cited by 9 publications

References 40 publications

Postoperative Swallowing Function in Patients with Deep Neck Infection

Postoperative Swallowing Function in Patients with Deep Neck Infection

Identification of Risk Factors for Mortality and Prolonged Hospitalization in Patients Treated With Surgical Drainage for Otogenic Intracranial Complications: A Nationwide Study Using a Japanese Inpatient Database

Risk factors of readmission and the impact of outpatient management in heart failure patients: A national study in Japan

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