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Objective <p>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.</p> Methods <p>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.</p> Results <p>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%).</p> Conclusion <p>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.</p>

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

  • 期刊论文

  • 发表日期：

    2026年1月12日

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  • Jakovljevic Sasa,
  • Arsovic Nenad,
  • Cvorovic Ljiljana,
  • Pavlovic Bojan,
  • Radivojevic Nemanja,
  • Jotic Ana,
  • Folic Miljan,
  • Jovanovic Katarina,
  • Mladenovic Neda,
  • Dragisic Milan

摘要

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.