2022 Fiscal Year Final Research Report
Identification of risk factors for mortality and delayed oral dietary intake in patients with open drainage due to deep neck infections: Nationwide study using a Japanese inpatient database.
Project/Area Number |
20K09699
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Research Category |
Grant-in-Aid for Scientific Research (C)
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Allocation Type | Multi-year Fund |
Section | 一般 |
Review Section |
Basic Section 56050:Otorhinolaryngology-related
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Research Institution | Kansai Medical University |
Principal Investigator |
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Co-Investigator(Kenkyū-buntansha) |
岩井 大 関西医科大学, 医学部, 教授 (10232638)
たら澤 邦男 東北大学, 医学系研究科, 講師 (30632806)
藤森 研司 東北大学, 医学系研究科, 教授 (80264539)
小原 拓 東北大学, 東北メディカル・メガバンク機構, 准教授 (80612019)
阪上 智史 関西医科大学, 医学部, 助教 (90541722)
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Project Period (FY) |
2020-04-01 – 2023-03-31
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Keywords | 深頸部膿瘍 / 降下性壊死性縦隔炎 / 嚥下障害 / 生命予後 / 医療大規模データ / 糖尿病 / 敗血症 |
Outline of Final Research Achievements |
Data on risk factors for deep neck infection including descending necrotizing mediastinitis (DNM) have been limited. Using a nationwide database, the aim was identifying the factors related to patient death and delay in recovering oral intake. Data of 4949 patients were extracted from a Japanese inpatient database between 2012 and 2017. The main outcome was survival at discharge. In a subgroup analysis of the 4949 patients with survival, the second outcome was delay in the interval between admission and full recovery of oral intake. Only a few factors (advanced-age, ventilation) were associated with both mortality and delayed oral dietary intake by logistic regression analyses. Conversely, several factors including DNM and repeated surgery were significantly related only to delayed oral dietary intake. Although DNM was not necessarily related to mortality, patients with DNM should receive careful attention to avoid delayed oral dietary intake.
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Free Research Field |
耳鼻咽喉科頭頸部外科
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Academic Significance and Societal Importance of the Research Achievements |
耳鼻咽喉科頭頸部外科領域の中でも生死にかかわる重症感染症である深頸部膿瘍、降下性縦隔炎について、医療大規模データをもちいてその生命予後、後遺症について詳細に検討したことで、その予防と治療を検討した。 世界的なデータとも比較することで、本邦の高水準の救急医療が認識されるとともに、今後の問題点や治療の着眼点にも言及した意義は大きいと考えられる。
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