China Journal of Oral and Maxillofacial Surgery ›› 2019, Vol. 17 ›› Issue (3): 257-260.doi: 10.19438/j.cjoms.2019.03.013

• Original Articles • Previous Articles     Next Articles

Early-warning function of C-reactive protein in diagnosis of descending necrotic mediastinitis

XIA Yun-hui1, QU Lu-yao2, LIANG Xiang3, JIANG Bin4, QIAN Wen-tao2, CAI Xie-yi2, ZHANG Wei-jie2, GUAN Xin3   

  1. 1.Department of Oral and Craniomaxillofacial Surgery;
    2.Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Center for Clinical Research of Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Institute of Stomatology. Shanghai 200011;
    3.Department of Thoracic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011;
    4. Department of Stomatology, Shanghai Renji Hospital,Shanghai Jiao Tong University School of Medicine. Shanghai 200001, China
  • Received:2018-11-12 Revised:2019-02-17 Online:2019-05-20 Published:2019-06-21

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Abstract: PURPOSE: The aim of this study was to compare clinical information of patients suffering from oral and maxillofacial multiple space infection patients with or without descending necrotic mediastinitis (DNM), to analyze the risk factors for DNM, so as to provide clinical support for early diagnosis and treatment of descending necrotic mediastinitis. METHODS: This study was a prospective cohort study. The patients with severe oral and maxillofacial and cervical multiple space infections who were referred to the Department of Oral Surgery at Shanghai Ninth People's Hospital, Shanghai Jiao Tong Tong University School of Medicine from December 2016 to December 2017 were included. The clinical data were recorded, such as gender, age, source of original infection, laboratory test, occurrence of DNM. According to whether DNM occurred, the patients were divided into two groups. Continuous variables were compared by t or t' test between the two groups, and discrete variables were analyzed with Fisher's exact test using SPSS 22.0 software package. RESULTS: Two hundred and one patients with oral and maxillofacial and cervical multiple space infection during 12 months were enrolled. 14 patients developed DNM, and the occurrence was 6.97%. Among 201 patients, there were 142 males and 59 females. The average age of patients was 52.98±17.12 years. The most common causes were periapical periodontitis in 90 cases, accounting for 44.8%, followed by pericoronitis of wisdom teeth in 50 cases (24.9%). In addition, the most commonly site of primary source was mandibular posterior teeth in 140 cases (69.7%). After univariate analysis, the site of onset (P<0.001), neutrophil percentage (P=0.004), C-reactive protein (P<0.001) had significant relationship with DNM. CONCLUSIONS: Secondary DNM is more likely to occur in patients with high level of C-reactive protein and neutrophil percentage .

Key words: Oral and maxillofacial and cervical multi-space infection, Descending necrotic mediastinitis, Risk factors, C-reactive protein

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