Predictors of mediastinitis in deep neck space infections - ten-year experience from tertiary referral center.

OBJECTIVE: The study aimed to identify causes of deep neck space infections and factors leading to severe complications and delayed healing. We also evaluated the LRINEC, NLR, and LRINEC x NLR indicators for predicting mediastinitis. To our knowledge, this is the first study to use LRINEC and LRINEC x NLR scores for mediastinitis prediction. METHODS: This retrospective study included 118 patients treated at our institution from January 1, 2014, to December 31, 2023, with phlegmon and infections of the deep neck spaces. RESULTS: Patients with mediastinitis exhibited significantly elevated LRINEC, NLR, and LRINEC x NLR scores. Fatal outcomes were associated with higher levels of LRINEC x NLR, CRP, and creatinine. ROC analysis determined cutoff values for these markers: LRINEC x NLR (AUC: 0.923, cutoff: 113.01, sensitivity: 86%, specificity: 85%), NLR (AUC: 0.872, cutoff: 19.0, sensitivity: 81%, specificity: 77%), and LRINEC (AUC: 0.832, cutoff: 5.5, sensitivity: 81%, specificity: 69%). CONCLUSION: Mediastinitis, as a complication of deep neck space infections, is not rare in these patients and significantly impacts prognosis. Based on our results, we believe that the LRINEC, NLR, and LRINEC x NLR scores can serve as predictive markers for the early assessment of these patients’ conditions and the potential development of mediastinitis.