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Maxillofacial space infection experience and risk factors: a retrospective study of 222 cases

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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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Acknowledgments

We are all grateful to all the patients who are the fundamental part of this study. We are grateful for the indirect support from the National Natural Science Foundation of China [81801025 (Y. Q.)], Suzhou Science and Technology Development Project (SS2019062 (Y. Q.)), “National Tutor System” Training Program for Young Talents in Suzhou Health System (Y. Q.) due to no direct funding available for this research.

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Authors and Affiliations

  1. Center of Stomatology, the Second Affiliated Hospital of Soochow University, No. 1055 Sanxiang Road, Suzhou, 215004, Jiangsu Province, People’s Republic of China

    Yunzhu Qian, Qi Ge, Wei Zuo, Xi Cheng, Danlei Xing & Jianxin Yang

  2. College of Dentistry, University of Illinois at Chicago, Chicago, IL, 60612, USA

    Maria Grace Costa Viana & Phimon Atsawasuwan

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  1. Yunzhu Qian
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  2. Qi Ge
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Correspondence to Yunzhu Qian.

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Qian, Y., Ge, Q., Zuo, W. et al. Maxillofacial space infection experience and risk factors: a retrospective study of 222 cases. Ir J Med Sci 190, 1045–1053 (2021). https://doi.org/10.1007/s11845-020-02431-z

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