Recurrent peritonsillar abscess in adults: Incidence and risk factors in a prospective longitudinal cohort
The incidence of recurrent peritonsillar abscess (7.4–22%) was estimated in retrospective studies. The aim of this prospective study was to estimate the cumulative incidence of recurrent peritonsillar abscess and related risk factors. We performed a prospective longitudinal cohort study. The study i...
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| Published in: | Acta otorrinolaringológica española (English) Vol. 75; no. 6; pp. 361 - 366 |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Spain
Elsevier España, S.L.U
01-11-2024
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | The incidence of recurrent peritonsillar abscess (7.4–22%) was estimated in retrospective studies. The aim of this prospective study was to estimate the cumulative incidence of recurrent peritonsillar abscess and related risk factors.
We performed a prospective longitudinal cohort study. The study included adult patients (≥18 years old) of both sexes who were attended in the emergency facilities of our tertiary hospital, without peritonsillar abscess background, diagnosed of a first episode of peritonsillar abscess and treated with standard of care (abscess drainage and antibiotics). Patients were followed for 24 months. Cumulative incidence of peritonsillar abscess recurrence was estimated and its 95% confidence interval was calculated; and predictive risk factors were assessed.
Between January 1st, 2019 and March 9th, 2020, a total of 181 consecutive patients were included. The cumulative incidence of recurrent peritonsillar abscess at 2 years of the diagnosis was 9.9% (18 out of 181, 95% CI: 6.4–15.2%). The only risk factor associated with recurrent peritonsillar abscess in multivariate analysis was low plasma glucose level at the time of emergency room attendance (HR: 0.46, 95% CI: 0.24–0.91, p-value: 0.026).
Peritonsillar abscess is an incident medical issue, with an established recurrence rate, but with unclear predictive risk factors of recurrence. Further studies are needed to assess the risk factor associated with recurrent peritonsillar abscess.
Este estudio longitudinal prospectivo tuvo como objetivo evaluar la incidencia y los factores de riesgo del absceso periamigdalino recurrente en adultos.
Todos los pacientes adultos consecutivos (> 18 años) que presentaron un primer episodio de absceso periamigdalino atendidos en el servicio de urgencias de un hospital de tercer nivel de Barcelona (España) fueron incluidos en un estudio de cohortes longitudinal prospectivo. Tras el tratamiento estándar de drenaje del absceso y antibioterapia, se realizó un seguimiento de los pacientes durante 2 años. La incidencia acumulada y los factores de riesgo de recurrencia del absceso periamigdalino se evaluaron mediante análisis de regresión logística.
La población de estudio incluyó 181 pacientes tratados entre enero de 2019 y marzo de 2020. Dieciocho pacientes desarrollaron absceso periamigdalino recurrente, con una tasa de incidencia acumulada a 2 años del 9,9% (intervalo de confianza [IC] del 95%: 6,4-15,2). El nivel bajo de glucosa en plasma al ingreso en el servicio de urgencias fue el único factor de riesgo independiente para la recurrencia del absceso periamigdalino (cociente de riesgos 0,46; IC del 95%: 0,24-0,91; p = 0,026).
Este estudio muestra que el absceso periamigdalino en pacientes adultos, aunque tratado adecuadamente, puede presentar una tasa de recurrencia cercana al 10% en un seguimiento de 2 años. Los clínicos deben ser conscientes de la posibilidad de recurrencia tras el tratamiento de un primer episodio de absceso periamigdalino en adultos, pero los factores de riesgo de recurrencia no están claros. |
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| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| ISSN: | 2173-5735 2173-5735 |
| DOI: | 10.1016/j.otoeng.2024.09.001 |