A clinical prediction score to determine surgical drainage of deep neck infection: A retrospective case-control study

Abstract

Background: The objective of this retrospective study was to identify predictors of an abscess guaranteed to be surgically drained successfully in patients with deep neck infection (DNI). Materials and methods: We divided 97 consecutive patients with DNI into a drained group and a non-drained group. We then developed a clinical prediction score and validated it in 32 further patients. Results: Significant predictors of successful surgical drainage (i.e., positive for pus) were rim enhancement on computed tomography, C-reactive protein, erythrocyte sedimentation rate, and the neutrophil to lymphocyte ratio. The estimated cut-off values (excluding rim enhancement, which is a yes/no parameter) were 41.25, 56.5, and 8.02, respectively, and the clinical prediction score for each of the four other factors was determined to be 2, 2, 3, and 3 points, respectively. The cut-off score for the sum of these points was 6.5 and the scoring system had an accuracy of 87.5% in the validation group. Conclusion: Our clinical prediction scoring system can predict whether drainage is successful in patients with DNI.