Maxillofacial Plastic and Reconstructive Surgery

  • Volume 41
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  • Pages.49.1-49.8
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  • 2019
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  • 2288-8101(pISSN)
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  • 2288-8586(eISSN)
Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
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A retrospective analysis of risk factors of oromaxillofacial infection in patients presenting to a hospital emergency ward

  • Park, Jinyoung (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University) ;
  • Lee, Jae-Yeol (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University) ;
  • Hwang, Dae-Seok (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University) ;
  • Kim, Yong-Deok (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University) ;
  • Shin, Sang-Hun (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University) ;
  • Kim, Uk-Kyu (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University) ;
  • Song, Jae-Min (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University)
  • Received : 2019.08.14
  • Accepted : 2019.10.25
  • Published : 2019.12.31
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Abstract

Background: The purpose of this study was to review the clinical features of oromaxillofacial infections in patients presenting to a hospital emergency ward, to identify the key factors affecting the requirement for hospitalization, and the potential risk factors predisposing to a prolonged length of hospital stay. Methods: A retrospective medical record review of the 598 patients treated for oromaxillofacial infection from 2013 to 2017 at the oral and maxillofacial surgery department, Yangsan Pusan National University Hospital, was conducted. The following information was collected from each patient: sex, age, past medical history, site of infection, etiology, admission or outpatient care, level of C-reactive protein (mg/dL), fascial spaces involved, treatment method, and duration of hospitalization. Chi-squared tests were used to identify risk factors, which were further analyzed using multivariable logistic regression. Results: A total of 606 patients were eligible for inclusion in the study, of which eight were excluded due to having incomplete charts; thus, 598 patients were included: 55% were male, mean patient age was 47.1 ± 19.9 years, and 12.9% of patients were diabetic. Furthermore, 71.2% of patients had infection originating in the mandible; the most common tooth of origin was lower posterior, and 29.8% of patients were hospitalized. Risk factors for hospital admission were elderly patients with concurrent disease, elevated C-reactive protein level, and multiple-space infection in the oromaxillofacial area. The duration of hospitalization was correlated with both diabetes and age. Conclusions: The requirement for hospital admission is determined by the severity of the infection; even severe infections, once treated with appropriate surgery, have no relation to the length of hospital stay. The important risk factors for increased duration of hospitalization are diabetes mellitus and older age. The understanding of risk factors associated with a prolonged hospital stay during the treatment of oromaxillofacial infection will aid in treatment planning as well as highlight the importance of adequate diabetes control in patients at risk of such infection.

Keywords

References

  1. Zhang CX, Tang YL, Zheng M, Yang J, Zhu GQ, Zhou H et al (2010) Maxillofacial space infection experience in West China: a retrospective study of 212 cases. Int J Infect Dis 14:E414-E4E7
  2. Ottaviani G, Costantinides F, Perinetti G, Luzzati R, Contardo L, Visintini E et al (2014) Epidemiology and variables involved in dental abscess: survey of dental emergency unit in Trieste. Oral Dis 20:499-504 https://doi.org/10.1111/odi.12164
  3. Mathew GC, Ranganathan LK, Gandhi S, Jacob ME, Singh I, Solanki M et al (2012) Odontogenic maxillofacial space infections at a tertiary care center in North India: a five-year retrospective study. Int J Infect Dis 16:E296-E302
  4. Rao DD, Desai A, Kulkarni RD, Gopalkrishnan K, Rao CB (2010) Comparison of maxillofacial space infection in diabetic and nondiabetic patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 110:E7-E12
  5. Wang J, Ahani A, Pogrel M (2005) A five-year retrospective study of odontogenic maxillofacial infections in a large urban public hospital. Intl J Oral Maxillofac Surg 34:646-649 https://doi.org/10.1016/j.ijom.2005.03.001
  6. Seppanen L, Lauhio A, Lindqvist C, Suuronen R, Rautemaa R (2008) Analysis of systemic and local odontogenic infection complications requiring hospital care. J Inf Secur 57:116-122
  7. Han X, An J, Zhang Y, Gong X, He Y (2016) Risk factors for life-threatening complications of maxillofacial space infection. J Craniofac Surg 27:385-390 https://doi.org/10.1097/SCS.0000000000002416
  8. Kim M, Nalliah R, Lee M, Allareddy V (2012) Factors associated with length of stay and hospital charges for patients hospitalized with mouth cellulitis. Oral Surg Oral Med Oral Pathol Oral Radiol 113:21-28 https://doi.org/10.1016/j.tripleo.2011.01.012
  9. Mirochnik R, Araida S, Yaffe V, Abu E-NI (2017) C-reactive protein concentration as a prognostic factor for inflammation in the management of odontogenic infections. Br J Oral Maxillofac Surg 55:1013-1017 https://doi.org/10.1016/j.bjoms.2017.10.006
  10. Alotaibi N, Cloutier L, Khaldoun E, Bois E, Chirat M, Salvan D (2015) Criteria for admission of odontogenic infections at high risk of deep neck space infection. Eur Ann Otorhinolaryngol Head Neck Dis 132:261-264 https://doi.org/10.1016/j.anorl.2015.08.007
  11. Gholami M, Mohammadi H, Amiri N, Khalife H (2017) Key factors of odontogenic infections requiring hospitalization: a retrospective study of 102 cases. J Oral Max Surg Med 29:395-399
  12. Zheng LY, Yang C, Zhang WJ, Cai XY, Jiang B, Wang BL et al (2013) Comparison of multi-space infections of the head and neck in the elderly and non-elderly: part I the descriptive data. J Craniomaxillofac Surg 41:E208-EE12 https://doi.org/10.1016/j.jcms.2013.01.020
  13. Zheng LY, Yang C, Zhang WJ, Cai XY, Jiang B, Wang BL et al (2015) Comparison of multi-space infections of the head and neck in the elderly and non-elderly people, part II: the influencing factors of the outcomes. J Craniomaxillofac Surg 26:581-584
  14. Jang JW, Kim CH, Kim MY (2015) Analysis of glycosylated hemoglobin (HbA1c) level on maxillofacial fascial space infection in diabetic patients. J Korean Assoc Oral Maxillofac Surg 41:251-258 https://doi.org/10.5125/jkaoms.2015.41.5.251
  15. Christensen B, Han M, Dillon JK (2013) The cause of cost in the management of odontogenic infections 2: multivariate outcome analyses. J Oral Maxillofac Surg 71:2068-2076 https://doi.org/10.1016/j.joms.2013.05.027
  16. Storoe W, Haug RH, Lillich T (2001) The changing face of odontogenic infections. J Oral Maxillofac Surg 59:739-748 https://doi.org/10.1053/joms.2001.24285
  17. Allareddy V, Rampa S, Nalliah R (2014) Longitudinal discharge trends and outcomes after hospitalization for mouth cellulitis and Ludwig angina. Oral Surg Oral Med Oral Pathol Oral Radiol 118:524-531 https://doi.org/10.1016/j.oooo.2014.06.003
  18. Flynn T, Shanti R, Hayes C (2006) Severe odontogenic infections, part 2: prospective outcomes study. J Oral Maxillofac Surg 64:1104-1113 https://doi.org/10.1016/j.joms.2006.03.031
  19. Sharma A, Giraddi G, Krishnan G, Shahi AK (2014) Efficacy of serum prealbumin and CRP levels as monitoring tools for patients with fascial space infections of odontogenic origin: a clinicobiochemical study. J Maxillofac Oral Surg 13:1-9 https://doi.org/10.1007/s12663-012-0376-4
  20. Ren YF, Malmstrom HS (2007) Rapid quantitative determination of Creactive protein at chair side in dental emergency patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 104:49-55 https://doi.org/10.1016/j.tripleo.2007.01.007
  21. Ylijoki S, Suuronen R, Jousimies-Somer H, Meurman JH, Lindqvist C (2001) Differences between patients with or without the need for intensive care due to severe odontogenic infections. J Oral Maxillofac Surg 59:867-872 https://doi.org/10.1053/joms.2001.25017
  22. Peters ES, Fong B, Wormuth DW, Sonis ST (1996) Risk factors affecting hospital length of stay in patients with odontogenic maxillofacial infections. J Oral Maxillofac Surg 54:1386-1391 https://doi.org/10.1016/S0278-2391(96)90249-9
  23. Barber B, Dziegielewski P, Biron V, Ma A, Seikaly H (2014) Factors associated with severe deep neck space infections: targeting multiple fronts. J Otolaryngol Head Neck Surg 43:35 https://doi.org/10.1186/s40463-014-0035-5
  24. Gams K, Shewale J, Demian N, Khalil K, Banki F (2017) Characteristics, length of stay, and hospital bills associated with severe odontogenic infections in Houston, TX. J Am Dent Assoc 148:221-229 https://doi.org/10.1016/j.adaj.2016.11.033
  25. YJ Kim, DongA newsletter, http://news.donga.com/3/all/20180426/89817305/1. Accessed 27 Apr 2018

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