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. 2018 Feb;100(2):129-134.
doi: 10.1308/rcsann.2017.0193. Epub 2017 Oct 19.

The hidden cost of deep neck space infections

R H Hurley  1 , C M Douglas  1 , J Montgomery  1 , L J Clark  1
Affiliations

The hidden cost of deep neck space infections

R H Hurley et al. Ann R Coll Surg Engl. 2018 Feb.

Abstract

Introduction The incidence of deep neck space infection (DNSI) is rising and appears to be related to falling rates of tonsillectomy. The purpose of this study was to assess demographics of patients presenting with DNSI and the financial burden to the National Health Service (NHS). Methods Data were collected retrospectively on patients aged over 16 years admitted to NHS Greater Glasgow and Clyde with DNSI between 2012 and 2016. Demographics, aetiology and use of hospital resources were reviewed. The cost of hospital admissions was calculated using data from NHS Scotland's Information Services Division, the local diagnostics division and the British National Formulary. Results Seventy-four patients were admitted with DNSI during the study period. Forty (54%) were male. The mean age was 44.0 years (range: 16-86 years). The most frequent source of infection was the tonsil (n=30, 40.5%). The most common infective organism was Streptococcus constellatus (n=9, 12.2%). The mean length of stay was 11 days. Fifty-five patients (74.3%) required operative intervention. The mean cost of admission per patient was £5,700 (range: £332-£46,700). Conclusions This study highlights the high cost burden of DNSI to the NHS. The incidence of DNSI in Glasgow has risen over the study period; contributing factors may include the reduced tonsillectomy rate and a reduction in antibiotic prescribing. As the incidence of DNSI continues to rise, there will be an increase in cost to the NHS, which must be planned for.

Keywords: Deep neck space infection; Neck abscess; Parapharyngeal abscess; Retropharyngeal abscess; Tonsillectomy.

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Figures

Figure 1
Figure 1
Number of patients presenting with deep neck space infection
Figure 2
Figure 2
Causative organisms demonstrated on microbiological swabs. ‘Other’ includes Candida albicans, Streptococcus salivarius, Mycobacterium tuberculosis, Staphylococcus epidermidis, group C streptococci], Streptococcus parasanguinis, coliform bacilli and Streptococcus pyogenes.
Figure3
Figure3
The number of patients presenting with various symptoms and signs
Figure 4
Figure 4
Complications encountered among the 74 patients
See this image and copyright information in PMC

References

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