PROGNOSTIC FACTORS IN CERVICAL NECROTIZING FASCIITIS

Necrotizing Fasciitis is a rapidly progressive soft tissue infection potentially life-threatening;
it can lead to septic vascular thrombosis, sepsis, organ failure, septic shock and even death. When it
occurs in cervical region the most dangerous complication is Mediastinitis.
Microbes, usually Gram-, penetrate the tissues via trauma, head and neck surgery,
odontogenic infections or abscess. Dental infections are quite common, but progression to
Necrotizing Fasciitis is relatively rare.
The aim of this study is to develop a score so that when a patient present with serious dental
infection we are able to set the risk of developing dangerous complications and, therefore, death.
We conducted a literature search on Pub Med of clinical cases of “Odontegenic Necrotizing
Fasciitis” and found 74 papers for a total of 108 patients. Every single case was analysed and
demographic information, symptoms, habits and co-morbidities were recorded and inserted in a
table for each patient. The presence or absence of any conditions assigned one point.
We observed that the score registered in the “Dead Group” (A) is higher than in “Alive
Group” (B) and T test demonstrated that the higher score in Group A had a statistical relevance, up
to 97,5%, compared to the score of all patients analysed; moreover, the score of Group A is higher,
with relevance up to of 99%, than Group B.
In order to assess the score discriminating of death risk in patients, we compared the total of
patients with Group A and B (Z test); results demonstrated that a score ≥6 occurs, significantly,
with higher frequency in the “Dead Group” than in “Alive Group”.
Therefore, this score is an effective tool for assessing the risk of CNF complications and
may be useful in clinical routine for rapidly discriminating life threatening conditions.