{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T14:13:56Z","timestamp":1790604836954,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T00:00:00Z","timestamp":1691539200000},"content-version":"vor","delay-in-days":39,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["OTO Open"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Describe features unique to head and neck (H&amp;N) necrotizing fasciitis (NF) compared to other anatomic regions and specify a prognostic score associated with death and descending necrotizing mediastinitis (DNM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Tertiary care, level 1 trauma center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single\u2010institution database identified 399 confirmed cases of NF between 2006 and 2021, 33 of which involved the H&amp;N. Patients with confirmed H&amp;N NF were sorted into cohorts based on clinical outcomes, with the \u201cpoor\u201d outcomes group defined by death and\/or DNM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty\u2010three patients with H&amp;N NF were included. Compared to NF of other regions, patients with H&amp;N NF had a significantly lower mortality rate (6.06% vs 20.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.041) and significantly lower rates of obesity (27.3% vs 63.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001) and hypertension (42.4% vs 60.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.038). Within the H&amp;N group, there were 2 deaths (6.06%) and 8 cases of DNM (24.2%). Diabetes was associated with poor outcomes (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.047), as was an abbreviated sequential organ failure assessment score for necrotizing fasciitis (nfSOFA) of 2 or greater (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.015).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>H&amp;N NF is unique among other forms of NF, with a lower mortality rate and lower rates of obesity and hypertension in affected patients. Within the H&amp;N cohort, worse outcomes were associated with diabetes as well as a nfSOFA score of 2 or greater. Timely surgical debridement alongside broad\u2010spectrum antibiotics remains the mainstay of treatment for NF; however, this simple prognostic score may play a role during the early stages of care for patients with H&amp;N NF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/oto2.68","type":"journal-article","created":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T04:22:25Z","timestamp":1691554945000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Head and Neck Necrotizing Fasciitis: Abbreviated SOFA Score Associated With Death and Infection Spread"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9683-5242","authenticated-orcid":false,"given":"Kelly L.","family":"Vittetoe","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Vanderbilt University Medical Center Nashville Tennessee 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