Independent risk factors associated with higher mortality rates and recurrence of brain abscesses from head and neck sources

The aim of this study was to identify the features and independent risk factors associated with recurrence and mortality in patients with brain abscesses of head and neck origin. We designed a retrospective study of patients diagnosed with a brain abscess at the Massachusetts General Hospital betwee...

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Published in:Oral surgery, oral medicine, oral pathology and oral radiology oral medicine, oral pathology and oral radiology, 2021-02, Vol.131 (2), p.173-179
Main Authors: Zhang, Fugui, Hsu, Grace, Das, Somdipto, Chen, Youbai, August, Meredith
Format: Article
Language:English
Subjects:
Adult
Aged
Brain Abscess
Dentistry
Head
Humans
Male
Middle Aged
Neck
Retrospective Studies
Risk Factors
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Summary:The aim of this study was to identify the features and independent risk factors associated with recurrence and mortality in patients with brain abscesses of head and neck origin. We designed a retrospective study of patients diagnosed with a brain abscess at the Massachusetts General Hospital between 1980 and 2017. Inclusion criteria were complete medical records, including medical and surgical history; and radiographic and microbiologic data. Multinomial logistic regression and Gray's test were used to evaluate the independent variables associated with recurrence and mortality. Eighty-eight cases met the inclusion criteria. Of these, 48 patients (54.5%) were men (mean age 50.5 ± 18.8 years). Significant association between etiology and cultured organisms was found only in cases of neurosurgical intervention with staphylococcal or streptococcal isolates (P < .05). Seizure activity was the only significant predictor of recurrence. Predictors of mortality included advanced age (P = .005); staphylococcal infection (P = .029); low monocyte count (P = .004); hyponatremia (P = .002); elevated blood urea nitrogen (P = .000); elevated creatinine (P = .002); hyperglycemia (P = .023); and status at discharge (P = .000). Independent risk factors, such as low monocyte count, hyponatremia, renal dysfunction, and hyperglycemia, were found to be associated with higher mortality rates in patients with brain abscesses of head and neck origin. These abnormalities should be promptly recognized and aggressively treated.
ISSN:2212-4403
2212-4411
DOI:10.1016/j.oooo.2020.08.026