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Lixandru CI, Maniu I, Cernuşcă-Miţariu MM, Domnariu CD. Oral infections - a retrospective study of patients treated in the Oral and Maxillofacial Surgery clinic of the Emergency County Clinical Hospital in Sibiu. Med Pharm Rep 2024; 97:380-389. [PMID: 39234456 PMCID: PMC11370852 DOI: 10.15386/mpr-2759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 06/22/2024] [Accepted: 07/10/2024] [Indexed: 09/06/2024] Open
Abstract
Background and aims The present study was carried out in the Department of Oral and Maxillo-Facial Surgery of the Sibiu County Emergency Clinical Hospital and aimed to evaluate the oral health status of patients who refer to this medical unit, identifying the presence and frequency of dental infections among these patients. The study also aimed to identify and characterize the comorbidities present in patients with these oral conditions. Finally, the study aims to highlight the degree of concern regarding the oral health status of patients and provide relevant information for dental health services and for the development of appropriate prevention and intervention strategies. Methods The study was conducted retrospectively and descriptively, using the hospital's electronic medical records. The total sample consisted of 1246 people, the inclusion criteria were: (a) patients admitted to the OMF Surgery Department; (b) outpatients who required hospitalization; (c) patients hospitalized under continuous hospitalization regime; (d) patients over 16 years of age; (e) patients diagnosed with infectious pathologies.After data registration, information on sex, background, distribution of diagnoses, associated pathologies of the patients and the existence of combined pathologies of the patients included in the study were taken into account. The duration of hospitalization of patients, the need and duration of antibiotic therapy, the frequency of use of combinations of antibiotics, and the number of antibiotics used in correlation with the duration of hospitalization were also analyzed.The data are presented as frequency and percentages. The combination of the most frequent associated pathologies was analyzed using an algorithm based on association rules and chord diagram was used for their visual representation. Statistical analyses were performed using IBM SPSS® (Statistical Package for the Social Science) version 20 and R software. Results The total sample consisted of a total of 1246 people. From the preliminary analysis, the majority of people in the sample, 68.5%, did not suffer from infectious conditions, while 31.5% were affected. Most of the patients came from the urban environment (61.73%) and were male (54.34%). Frequent comorbidities included cardiac pathologies (11.99%) and diabetes (4.08%).These data indicate the poor state of oral health among patients who call on the OMF Surgery services. It is not an isolated case, but it reflects a pattern observed globally. Based on the results of the study, the hypothesis is validated that there is a poor state of oral health among the population, manifested by the increased incidence of dental infections. International studies confirm that dental infections are often complicated by the presence of comorbidities. Conclusion The study concludes that patients hospitalized in the department of Oral and Maxillofacial Surgery face a poor oral health state, characterized by a high prevalence of dental infections. The presence of comorbidities and seasonal factors contribute to the aggravation of these infections. These results emphasize the need for preventive and educational interventions to improve the oral health of the population in this region, as well as the development of personalized treatment strategies.
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Affiliation(s)
| | - Ionela Maniu
- Mathematics and Informatics Department, Faculty of Sciences, Research Center in Informatics and Information Technology, “Lucian Blaga” University, Sibiu, Romania
- Research Team, Pediatric Clinical Hospital, Sibiu, Romania
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Gadicherla S, Manglani K, Pentapati KC, Kudva A, Aramanadka C, Chandravel R. Profile of Patients with Maxillofacial Space Infections and Associated Risk Factors. ScientificWorldJournal 2024; 2024:9304671. [PMID: 38633105 PMCID: PMC11022519 DOI: 10.1155/2024/9304671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/27/2024] [Accepted: 03/30/2024] [Indexed: 04/19/2024] Open
Abstract
Objective To evaluate the profile of patients operated for maxillofacial space infections and associated risk factors for the length of hospital stay. Materials and Methods We conducted a retrospective study among patients operated for maxillofacial infections at our center from 2010 to 2020. Information collected from the records were age, sex, type and number of spaces involved, clinical signs and symptoms (pain, swelling, toothache, sore throat, otalgia, hoarseness, headache, cough, neck swelling, rancid breath, sialorrhea, gingival swelling, muffled voice, trismus, fever, dysphagia, odynophagia, malaise, lymphadenopathy, dyspnoea, pus discharge), treatment modality, total leukocyte count, evidence of bacterial growth, comorbidities, complications if any and length of hospital stay. Results A total of 128 medical records were examined, out of which 59 were female. The mean age was 38.59 ± 19.7 and the length of hospital stay was 7.56 ± 3.8 days. The most commonly involved space was submandibular space (46.1%) and the common symptoms reported were swelling (99.2%), pain (86.7%), and trismus (68%). Four patients had complications like necrotizing fasciitis (1.6%), pneumonia (0.8%), and death in one patient (0.8%). Logistic regression showed that patients more than 36 years of age, male sex, evidence of bacterial growth, and diabetics had higher odds of increased hospital stay (>6 days). Multiple logistic regression analysis showed that age (P = 0.015; OR: 2.98) and evidence of bacterial culture (P = 0.001; OR:6.64) were potential predictors associated with increased hospital stay. Conclusion Our study showed that the age of the patient and evidence of bacterial culture were potential predictors of prolonged hospital stay among patients operated for maxillofacial space infections.
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Affiliation(s)
- Srikanth Gadicherla
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Kirti Manglani
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Kalyana C. Pentapati
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Adarsh Kudva
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Chithra Aramanadka
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
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Zhou J, Wan T, Miao R, Tang W, Liu L, Long J, Jing W. Oral and maxillofacial emergencies: A retrospective study of 5220 cases in West China. Dent Traumatol 2023; 39:140-146. [PMID: 36366969 DOI: 10.1111/edt.12798] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 10/07/2022] [Accepted: 10/08/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND/AIM There are no epidemiological reports focused on the oral and maxillofacial surgery emergency department in the West China Hospital of Stomatology. The aim of this study was to analyse the epidemiological characteristics of emergency patients admitted for Trauma and Plastic Surgery Department of the West China Hospital of Stomatology from 2016-2019. MATERIALS AND METHODS In this retrospective study, 5220 patients with complete medical records were evaluated. The following data were collected: gender, age, etiology, disease type distribution, anatomic injury site and treatment modality. RESULTS There were 3046 males and 2174 females (ratio 1.40:1), with an average age of 16.2 years. The largest group was children aged between 3 and 6 years old (28.3%). Maxillofacial injuries were the most common condition (87.3%), which mostly occurred on the forehead (29.7%), followed by the lips (27.8%). A fall was the leading cause of injury (59.9%), especially in patients younger than 6 years old. There were 327 cases of maxillofacial space infections (MSI), and the mandibular third molars were the most common tooth associated with odontogenic infections (36.2%). Univariable analysis identified that multiple-space infection, visit time and systemic conditions were the risk factors for being admitted to the hospital for treatment. There were 116 patients (2.2%) with bleeding as the main complaint, and most of the maxillofacial bleeding patients could be stopped by compression (52.6%). CONCLUSION Males and children aged younger than 6 years were the highest risk populations. Trauma accounted for the majority of emergency patients in maxillofacial surgery. Most maxillofacial injuries involved the forehead and were mainly caused by accidental falls. The proportion of MSI was not high, but serious cases may be life-threatening. The causes of bleeding were diverse, and the bleeding was easy to control.
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Affiliation(s)
- Jing Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Southwest Medical University, Luzhou, China
| | - Ting Wan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Stomatology, Affiliated Hospital of Sichuan Nursing Vocational College, Chengdu, China
| | - Rong Miao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wei Tang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lei Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jie Long
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wei Jing
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Aditya NK, Lakshmi S, Bharani S. Prognostic determinants in severe odontogenic space infections: a single-center retrospective analysis. Minerva Dent Oral Sci 2023; 72:1-7. [PMID: 36197276 DOI: 10.23736/s2724-6329.22.04556-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Odontogenic space infections are a common presentation in oral and maxillofacial surgery units worldwide. Multiple patient and treatment dependent variables may be used predict the outcomes of the disease process. This study was aimed at a retrospective evaluation of significant predictors of prognosis in terms of length of hospital stay and the need for re-exploration in cases of odontogenic space infections. METHODS Patients who underwent incision and drainage of odontogenic space infections were identified from the hospital records of the Department of Oral and Maxillofacial Surgery, College of Dental Sciences, Davangere, Karnataka, India. The variables assessed included Diabetic status, pyrexia on admission, topical rubefacient agent application, hot fomentation, recent tooth extraction, trismus, dysphagia or dyspnea on presentation, white blood cell count, number of spaces involved, antibiotics used, organisms isolated, severity of the infection and the anesthesia technique used (local anesthesia [LA], conscious sedation or general anesthesia). RESULTS The sample consisted of 259 patients (110 male, 159 female) with a mean age of 41±16.9 years. Space infections were preceded by tooth extractions in 53 (20%) cases, rubefacient balm application in 130 (40%) and hot fomentation in 58 (22%) cases. Trismus was noted in 140 patients with an average mouth opening of 21±10.3 mm. Dyspnea and dysphagia were noted in 55 (21%) and 96 (37%) patients each. Sixty-six patients were diabetic. The average length of hospital stay was 5.8±3 days and re-exploration was required in 75 (29%) patients. Significant predictors of hospital stay were severity (P<0.001), number of spaces affected (P<0.001), hot fomentation (P=0.04), trismus (P<0.001), dysphagia (P<0.001) and dyspnea (P<0.001). Predictors of re-exploration are an increased primary surgery under LA (P<0.001), white blood cell count (P<0.001), rubefacient balm application (P=0.045), dysphagia (P<0.001), dyspnea (P=0.018), and reduced mouth opening (P<0.001). No significant correlation between diabetes and length of hospital stay or the need for re-exploration were found in this study. CONCLUSIONS Poorer outcomes can be predicted based on the severity of the infection, the number of spaces involved, an increased white blood cell count as well as clinical signs and symptoms like trismus, dysphagia and dyspnea. Hot fomentation and Rubefacient agent application were identified as significant determinants of poor prognosis in this study. The presence of these indicators warrants a more aggressive approach towards management of space infections.
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Affiliation(s)
- Nagarajan K Aditya
- Department of Dentistry (OMFS), Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India -
| | - Subha Lakshmi
- Department of Oral and Maxillofacial Surgery, College of Dental Sciences, Davangere, India
| | - Shiva Bharani
- Department of Oral and Maxillofacial Surgery, College of Dental Sciences, Davangere, India
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Inflammatory Markers as Predictors for Prolonged Duration of Hospitalization in Maxillofacial Infections. J Clin Med 2023; 12:jcm12030871. [PMID: 36769517 PMCID: PMC9917481 DOI: 10.3390/jcm12030871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/13/2023] [Accepted: 01/19/2023] [Indexed: 01/25/2023] Open
Abstract
Despite the progress made in diagnosing and treating maxillofacial infections, the course of infection can be unpredictable, leading to severe complications, prolonged hospitalization, and substantial financial costs to health care services. It is important to determine whether various serum inflammatory marker levels on admission may predict a prolonged hospital stay in these patients. To analyze the role of CRP, white blood cell count (WBC), and neutrophil-to-lymphocyte ratio (NLR) in predicting the prolonged duration of hospitalization in maxillofacial infections, we performed a retrospective study by collecting paper records data from 108 patients who met our inclusion criteria. The patients were divided into two groups according to the duration of hospitalization (group A < 5 days and group B ≥ 5 days). The predictor variables were CRP, WBC, and NLR, and the outcome variable was the duration of hospitalization. This study confirmed a positive linear correlation (p < 0.001) between the predictors and the outcome variable. The optimal cut-off values for WBC are 11,030 white blood cells/μL and 63 mg/L for CRP. Levels that exceed these optimal values predict a duration of hospitalization of over (≥) 5 days. Serum WBC and CRP on admission may predict the duration of hospitalization in patients with MFI.
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Computed tomography analysis of fascial space involvement demonstrates correlations with laboratory tests, length of hospital stays and admission to the intensive care unit in odontogenic infections. Braz J Otorhinolaryngol 2022; 88 Suppl 4:S170-S176. [PMID: 35659711 DOI: 10.1016/j.bjorl.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/25/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Odontogenic infections are frequent and can spread, leading to complications such as sepsis and the need for admission to an Intensive Care Unit (ICU). The purpose of this study was to perform a computed tomography analysis of the fascial space involvement and correlate with personal data, laboratory tests, length of hospital stays and admission to the ICU in patients with odontogenic infections who required hospitalization. METHODS Patients with odontogenic infections admitted between June 2017 and May 2018 were prospectively evaluated. The fascial spaces involved were studied using computed tomography with contrast. The possible correlations of tomographic findings with comorbidities, nutritional status, the causative tooth, laboratory tests, length of hospital stays and admission to the ICU were analyzed. RESULTS We identified 66 cases of odontogenic infections which were admitted in the period analyzed. The involvement of primary spaces (86.7%) predominated, followed by secondary ones (8.7%), and cervical (4.6%). The most frequently involved fascial spaces were submandibular (27.1%), buccal (20.8%), sublingual (18.3%), submental (16.7%), and others (17.1%). There were significant differences between laboratory tests (p < 0.001), mean hospital stays (p < 0.001), and admissions to the ICU (p < 0.001) depending on the number of fascial spaces involved. There was no influence of comorbidities, nutritional status, or causative tooth on fascial space involvement. CONCLUSION There was a relationship between greater involvement of fascial spaces assessed by computed tomography and higher values of laboratory tests, more extended hospitalization stays and admission to the ICU. LEVEL OF EVIDENCE Level 2b.
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Faustova M, Nazarchuk O, Loban’ G, Avetikov D, Ananieva M, Chumak Y, Havryliev V. Microbiological Aspects Concerning the Etiology of Acute Odontogenic Inflammatory Diseases in the Soft Tissues of the Head and Neck Region. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Odontogenic purulent inflammatory diseases (OPID) make up about 20% of cases in the structure of general surgical pathology and are among the frequent diseases of the maxillofacial region (MFR) with a high (10-40%) mortality rate. Insufficient information about the source state of acute odontogenic inflammation of the peri-mandibular soft tissues significantly reduces the effectiveness of diagnostic measures of OPID in MFR, as evidenced by almost 50% of the diagnostic error rate.
Statistically, OPID in soft-tissue of MFR most often occur due to dissemination of pathogens of the necrotized pulp, periodontal pockets in periodontitis or pericoronitis during the difficult eruption of retained teeth. Previously, the quantitative dominance (about 70%) of Staphylococcus spp. among the microorganisms isolated from the odontogenic foci of inflammation was determined. However, in recent years, with the expansion of microbiological diagnostic capabilities, the presence of non-fermenting Gram-negative bacteria and anaerobes with a significant proportional proportion of the total microbiota of OPID in soft tissue of MFR has been increasingly indicated.
Recently, there has been a rapid acquisition of resistance of pathogens of odontogenic purulent inflammatory diseases of the maxillofacial region to various groups of antibiotics, which leads to ineffectiveness of their treatment and prompts the revision of existing protocols and treatment regimens in surgical dentistry
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Hammad Y, Neal TW, Schlieve T. Admission C-reactive protein, WBC count, glucose, and body temperature in severe odontogenic infections: a retrospective study using severity scores. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 133:639-642. [PMID: 34975007 DOI: 10.1016/j.oooo.2021.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/12/2021] [Accepted: 11/08/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The purpose of this study was to determine whether various serum marker levels (C-reactive protein [CRP], white blood cell [WBC] count, glucose) or body temperature at admission are associated with severity of odontogenic infections. STUDY DESIGN This retrospective chart review of patients admitted to the hospital for treatment of severe odontogenic infections (SOIs) over a 5-year period (2016-2020) assigned patients with a severity score (SS) ≥5 to group A and those with an SS <5 to group B. Serum marker levels and temperature at admission were collected, and comparisons between group A and group B were conducted for serum marker levels and body temperature at admission using 2-sample t tests. RESULTS The mean serum CRP and temperature at admission between the 2 groups was not statistically significant (P > .05). The mean WBC count and serum glucose at admission between the 2 groups was statistically significant (P = .001 and P = .036, respectively). CONCLUSIONS This study demonstrates that serum glucose and WBC at admission are significantly higher in patients with more SOIs. In addition, serum CRP and body temperature at admission are not adequate prognostic indicators of odontogenic infection severity.
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Affiliation(s)
- Yousef Hammad
- Department of Surgery, Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, USA
| | - Timothy W Neal
- Department of Surgery, Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, USA
| | - Thomas Schlieve
- Department of Surgery, Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, USA
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Yew CC, Ng MP, Khoo SE, Ling XF, Yuen KM, Tew MM. Multivariate Analysis on Orofacial Odontogenic Infection in Northern Peninsular Malaysia. J Oral Maxillofac Surg 2021; 80:736-743. [PMID: 34863695 DOI: 10.1016/j.joms.2021.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/04/2021] [Accepted: 11/04/2021] [Indexed: 01/22/2023]
Abstract
PURPOSE This regional 2-center study was designed 1) to analyze the clinical features of all patients with odontogenic orofacial infection as per type of visit, 2) to analyze the clinical features of diabetic patients compared with nondiabetic patients, and 3) to identify potential variables that may associate with long length of stay (LOS) of patients admitted for orofacial odontogenic infection in Northern Peninsular Malaysia. PATIENTS AND METHODS All adult patients with orofacial odontogenic infections who attended the Oral and Maxillofacial Department of Hospital Raja Permaisuri Bainun and Hospital Sultan Abdul Halim from March 2015 to February 2019 were included. Data on patients' demography, medical history, smoking status, clinical presentation, and LOS were collected. Multivariate logistic regression analysis was performed using the dichotomous dependent variable, namely, short LOS (LOS <5 days) and long LOS (LOS ≥5 days). RESULTS A total of 355 patients were reported with the mean age of 39.93 ± 15.95 years old. Multivariate analysis revealed that diabetes (adjusted odds ratio = 4.387, 95% confidence interval = 1.453 to 13.241, P value = .009) and multiple space involvement (adjusted odds ratio = 4.859, 95% confidence interval = 1.280, 18.454, P value = .020) were responsible for long LOS. CONCLUSIONS Judicious treatment is recommended when treating patients of such infection that involves multiple spaces with underlying diabetes mellitus.
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Affiliation(s)
- Ching Ching Yew
- Specialist, Oral and Maxillofacial Surgery Department, Hospital Sultan Abdul Halim, Kedah, Ministry of Health, Kedah, Malaysia
| | - Mee Poh Ng
- Resident, Oral and Maxillofacial Surgery Department, Hospital Sultan Abdul Halim, Kedah, Ministry of Health, Kedah, Malaysia.
| | - Su Ee Khoo
- Resident, Oral and Maxillofacial Surgery Department, Hospital Raja Permaisuri Bainun, Perak, Ministry of Health, Perak, Malaysia
| | - Xiao Feng Ling
- Department Head, Oral and Maxillofacial Surgery Department, Hospital Sultan Abdul Halim, Kedah, Ministry of Health, Kedah, Malaysia
| | - Kar Mun Yuen
- Department Head, Oral and Maxillofacial Surgery Department, Hospital Raja Permaisuri Bainun, Perak, Ministry of Health, Perak, Malaysia
| | - Mei Mei Tew
- Pharmacist, Clinical Research Centre, Hospital Sultan Abdul Halim, Kedah, Ministry of Health, Kedah, Malaysia
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Significant increase in hospital admissions for the management of severe dental infection in England 2000-2020. J Infect 2021; 83:496-522. [PMID: 34289400 DOI: 10.1016/j.jinf.2021.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/21/2022]
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Kim HW, Kim CH. Factors associated with treatment outcomes of patients hospitalized with severe maxillofacial infections at a tertiary center. J Korean Assoc Oral Maxillofac Surg 2021; 47:197-208. [PMID: 34187960 PMCID: PMC8249195 DOI: 10.5125/jkaoms.2021.47.3.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 05/06/2021] [Accepted: 05/11/2021] [Indexed: 11/09/2022] Open
Abstract
Objectives The purpose of this retrospective study was to evaluate the variables associated with length of stay (LOS), hospital costs, intensive care unit (ICU) use, and treatment outcomes in patients hospitalized for maxillofacial infections at a tertiary medical center in South Korea. Materials and Methods A retrospective chart review was conducted for patients admitted for treatment of maxillofacial infections at Dankook University Hospital from January 1, 2011 through September 30, 2020. A total of 390 patient charts were reviewed and included in the final statistical analyses. Results Average LOS and hospital bill per patient of this study was 11.47 days, and ₩4,710,017.25 ($4,216.67), respectively. Of the 390 subjects, 97.3% were discharged routinely following complete recovery, 1.0% expired following treatment, and 0.8% were transferred to another hospital. In multivariate linear regression analyses to determine variables associated with LOS, admission year, infection side, Flynn score, deep neck infection, cardiovascular disease, admission C-reactive protein (CRP) and glucose levels, number and length of surgical interventions, tracheostomy, time elapsed from admission to first surgery, and length of ICU stay accounted for 85.8% of the variation. With regard to the total hospital bill, significantly associated variables were age, type of insurance, Flynn score, number of comorbidities, admission CRP, white blood cell, and glucose levels, admission temperature, peak temperature, surgical intervention, the length, type, and location of surgery, tracheostomy, time elapsed from admission to first surgery, and length of ICU use, which accounted for 90.4% of the variation. Age and ICU use were the only variables significantly associated with unfavorable discharge outcomes in multivariate logistic regression analysis. Conclusion For successful and cost-effective management of maxillofacial infections, clinicians to be vigilant about the decision to admit patients with maxillofacial infections, perform appropriate surgery at an adequate time, and admit them to the ICU.
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Affiliation(s)
- Hye-Won Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Cheonan, Korea
| | - Chul-Hwan Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Cheonan, Korea
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Su Z, Huang J, Chen W, Sun A, Bai X, Huang L, Weng S, Chen M. High diagnostic value of plasma fibrinogen for osteomyelitis of the jaws after oral cancer surgery. Oral Dis 2021; 28:1907-1910. [PMID: 33974318 DOI: 10.1111/odi.13911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 04/12/2021] [Accepted: 05/02/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Zhiming Su
- Department of Orthopedic Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jiyue Huang
- Department of Orthopedic Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Wenhao Chen
- Department of Orthopedic Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - An'an Sun
- Department of Orthopedic Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xinxin Bai
- Department of Orthopedic Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Lingling Huang
- Department of Stomatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Shaohuang Weng
- Department of Pharmaceutical Analysis, School of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Min Chen
- Department of Orthopedic Surgery, Fujian Medical University Union Hospital, Fuzhou, China
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Maxillofacial space infection experience and risk factors: a retrospective study of 222 cases. Ir J Med Sci 2020; 190:1045-1053. [PMID: 33188628 DOI: 10.1007/s11845-020-02431-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 11/05/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Maxillofacial space infection (MSI) experience review is beneficial for its management. AIM To identify potential risk factors predisposing to the exacerbation of MSI and a prolonged length of stay (LOS). METHODS We performed a comprehensive retrospective review of medical records of 222 MSI patients admitted in Center of Stomatology during 1993-2019. RESULTS About 63.5% of 222 patients had an odontogenic infection, and submandibular space was the most involved space. Streptococcus spp. was the most common organism isolated (72.4%). Multiple-space cases had more systemic diseases, respiratory difficulty, and life-threatening complications and exhibited worse clinical characteristics (higher white-blood-cell-count, higher body temperature, and restricted mouth opening) than single-space cases (P < 0.05). No significant difference in LOS was found between multiple-space cases and single-space cases. Diabetes and hypertension both accounted for 35.1% in life-threatening cases. Multiple-space infection (60.4%), respiratory difficulty (11.7%), and systemic conditions (43.2%) were identified as critical risk factors associated with life-threatening complications in MSI patients (P < 0.001). A significantly prolonged LOS was found in cases aged ≥ 60 years or with systemic diseases. Community outpatient treatment shortened 1.9 days of LOS compared with self-medication before admission during 2010-2019 (P < 0.05). CONCLUSION Comprehensive managements are advisable for MSI patients with multiple-space infection, respiratory difficulty, systemic diseases to avoid disseminated exacerbation, and occurrence of life-threatening complications. Community outpatient treatment was beneficial to a reduced LOS. Timely access to dental outpatient management and simultaneously steady control of diabetes and hypertension was advocated. Improved coverage of insured dental outpatient treatment should be stressed.
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