Severity Score as a Prognostic Factor for Management of Infections of Odontogenic Origin, a Study of 100 Cases

Abstract

Purpose: The main objective of the current study is to determine whether it is possible to correlate the longevity of the hospitalization period (LOS) to efficacy of surgical treatment regime and severity scoring. Materials and Methods: A total of 100 patients met our inclusion criteria. All patient records, including results of hematologic and biochemical parameters, were recorded. The patients were later subcategorized further according to a severity score ("Low, Moderate, Severe") of their main facial space involvement. The main analysis of the study is a regression analysis model; all the variables (sex, age, CRP, white blood cell count, fever, space, and etiology) were stratified according to the overall hospital stay. A crosstab comparison was performed next; the variables were categorized and combined with hospital stay, and then entered in Spearman's rank correlation coefficient or Spearman's rho (ρ), 2-tailed (t) Test, and regression equation. The significance level was set at p < 0.05. Statistical analyses were conducted using SPSS version 23. Results: The most prevalent anatomical space infection was vestibular space abscess or cellulitis 33%, followed by an infraorbital space abscess or cellulitis 17%. Most commonly involved teeth are lower molars with 43% of the total, upper central sixth with 20% and upper molars with 10%; mandibular origin was found to be the cause in 54%. The regression equation showed no linear relation between CRP with the overall hospital stay (p > 0.05). No systemic temperature values were found to be correlated to any space involved or LOS. Logrank chi-square effect tests indicated only a significant effect of severity, p = 0.00016. The "Moderate & Severe" group compared to the "Low" group had a longer median LOS, 4.5 (2 to 8) vs 3 (1 to 8) respectively. Conclusion: The findings of this study have shown severity scoring to be statistically significant parameter in LOS prediction.

Indicadores clínicos e laboratoriais como determinantes de um padrão na evolução das infecções orais graves - Estudo retrospectivo de 3 anos

“…Os casos mais graves e com maiores complicações foram observados nas infecções com origem na mandíbula, principalmente na região posterior, o que está de acordo com a literatura. (Edwards et al, 2004;Mirochnik et al, 2017;Yuvaraj, 2016). A frequência de infecção do espaço cervical profundo foi significativamente maior em pacientes com infecção odontogênica mandibular (29% dos pacientes) do que naqueles com infecções odontogênicas maxilares (7%).…”