Assessment of Severity of Illness and Monitoring Response to Treatment of Odontogenic Space Infection Using Serum Prealbumin

  • Peter Olalekan Adeosun
  • Olawunmi Adedoyin Fatusi
  • Tewogbade Adeoye Adedeji
Original Article



To assess Serum Prealbumin in the severity of illness and monitor response to treatment in odontogenic space infection.

Patients and Methods

This was a prospective cohort study comprising patients being managed for odontogenic space infection at the Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria. The calculated sample size was 69. Clinical parameters (Swelling Size, Visual Analogue Scale for pain intensity, and Maximal Interincisal Distance) were measured on day 0, day 4, and day 8. Other clinical parameters were Number of Anatomic Spaces Involved, setting of treatment, and Length of Hospital Stay. Serum Prealbumin levels were also serially measured. The relationship between Serum Prealbumin level and the clinical parameters was established using Spearman’s correlation test, independent t test, Friedman’s test, and linear regression. Significance level was set at .05.


The mean Serum Prealbumin level at presentation (day 0) was 19.19 ± 4.61 mg/dl, which was significantly lower among inpatients (p = 0.001). On days 0, 4, and 8, Serum Prealbumin negatively correlated with Number of Anatomic Spaces Involved (p < 0.001). Serum Prealbumin levels on days 0, 4, and 8 and response in Serum Prealbumin negatively correlated with Length of Hospital Stay. On each day, Serum Prealbumin negatively correlated with pain intensity and Swelling Size and positively correlated with mouth opening. The response in Serum Prealbumin also positively correlated with response in each of the three clinical parameters.


This study suggests that Serum Prealbumin is a reliable tool for grading severity of illness and monitoring response to treatment in odontogenic space infection.


Odontogenic space infection Serum Prealbumin Severity Response Clinical parameters 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interests.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.


  1. 1.
    Akinbami BO, Akadiri O, Gbujie DC (2010) Spread of odontogenic infections in Port Harcourt, Nigeria. J Oral Maxillofac Surg 68(10):2472–2477CrossRefPubMedGoogle Scholar
  2. 2.
    Vieira F, Allen SM, Stocks RM, Thompson JW (2008) Deep neck infection. Otolaryngol Clin North Am 41(3):459–483CrossRefPubMedGoogle Scholar
  3. 3.
    Sharma A, Giraadi G, Krishnan G, Shahi AK (2012) 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):1–4CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Zheng L, Yang C, Zhang W, Cai X, Kim E, Jiang B et al (2012) Is there association between severe multispace infections of the oral maxillofacial region and diabetes mellitus? J Oral Maxillofac Surg 70(7):1565–1572CrossRefPubMedGoogle Scholar
  5. 5.
    Cachovan G, Boger RH, Giersdorf I, Hallier O, Streichert T, Haddad M et al (2011) Comparative efficacy and safety of Moxifloxacin and clindamycin in the treatment of odontogenic abscesses and inflammatory infiltrates: a phase II, double-blind, randomized trial. Antimicrob Agents Chemother 55(3):1142–1147CrossRefPubMedGoogle Scholar
  6. 6.
    Drazic R, Jurisic M, Markovic A, Colic S, Gacic B, Stojcev-Stajcic L (2011) C-reactive protein as an inflammatory marker in monitoring therapy effectiveness of acute odontogenic infections. Srp Arh Celok Lek 139(7–8):446–451CrossRefPubMedGoogle Scholar
  7. 7.
    Lopez-Piriz R, Aguilar L, Gimenez MJ (2007) Management of odontogenic infection of pulpal and periodontal origin. Med Oral Patol Oral Cir Bucal 12(2):E154–E159PubMedGoogle Scholar
  8. 8.
    Zamiri B, Hashemi SB, Hashemi SH, Rafiee Z, Ehsani S (2012) Prevalence of odontogenic deep head and neck spaces infection and its correlation with length of hospital stay. J Dent (Shiraz) 13(1):29–35Google Scholar
  9. 9.
    Callaham M (1986) Inaccuracy and expense of the leukocyte count in making urgent clinical decisions. Ann Emerg Med 15(7):774–781CrossRefPubMedGoogle Scholar
  10. 10.
    Bakathir AA, Moos KF, Ayoub AF, Bagg J (2009) Factors contributing to the spread of odontogenic infections: a prospective pilot study. Sultan Qaboos Univ Med J 9(3):296–304PubMedPubMedCentralGoogle Scholar
  11. 11.
    Husain TM, Kim DH (2002) C-reactive protein and erythrocyte sedimentation rate in orthopaedics. UPOJ 15:13–16Google Scholar
  12. 12.
    Epstein FH, Gabay C, Kushner I (1999) Acute-phase proteins and other systemic responses to inflammation. N Engl J Med 340(6):448–454CrossRefGoogle Scholar
  13. 13.
    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(8):867–872CrossRefPubMedGoogle Scholar
  14. 14.
    Cunningham LL Jr, Madsen MJ, Van Sickels JE (2006) Using prealbumin as an inflammatory marker for patients with deep space infections of odontogenic origin. J Oral Maxillofac Surg 64(3):375–378CrossRefPubMedGoogle Scholar
  15. 15.
    Sann L, Bienvenu F, Bienvenu J, Bourgeois J, Bethenod M (1984) Evolution of serum prealbumin, C-reactive protein, and orosomucoid in neonates with bacterial infection. J Pediatr 105(6):977–981CrossRefPubMedGoogle Scholar
  16. 16.
    Shenkin A (2006) Serum prealbumin: is it a marker of nutritional status or of risk of malnutrition? Clin Chem 52(12):2177–2179CrossRefPubMedGoogle Scholar
  17. 17.
    Bijur PE, Silver W, Gallagher EJ (2001) Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med 8(12):1153–1157CrossRefPubMedGoogle Scholar
  18. 18.
    Chima O, Obiechina AE (1995) Mouth opening among Nigerians. Odonto-Stomatologie Tropicale 18(70):22–24Google Scholar
  19. 19.
    Rattanasompattikul M, Molnar MZ, Zaritsky JJ, Hatamizadeh P, Jing J, Norris KC et al (2013) Association of malnutrition-inflammation complex and responsiveness to erythropoiesis-stimulating agents in long-term hemodialysis patients. Nephrol Dial Transplant 28(7):1936–1945CrossRefPubMedGoogle Scholar
  20. 20.
    He T, An X, Mao H-P, Wei X, Chen J-H, Guo N et al (2013) Malnutrition–inflammation score predicts long-term mortality in Chinese PD patients. Clin Nephrol 79(6):477–483CrossRefPubMedGoogle Scholar
  21. 21.
    Bobbio A, Alifano M, Lupo A, Roche N, Regnard J-F, Cremer I et al (2014) Systemic inflammation, nutritional status and tumor immune microenvironment determine outcome in resected non-small cell lung cancer. Eur Respir J 44(Suppl 58):505Google Scholar
  22. 22.
    Bourguignat A, Ferard G, Jenny JY, Gaudias J, Kempf I (1996) Diagnostic value of C-reactive protein and transthyretin in bone infections of the lower limb. Clin Chim Acta 255(1):27–38CrossRefPubMedGoogle Scholar
  23. 23.
    Hansson LO, Hedlund JU, Ortqvist AB (1997) Sequential changes of inflammatory and nutritional markers in patients with community-acquired pneumonia. Scand J Clin Lab Invest 57(2):111–118CrossRefPubMedGoogle Scholar
  24. 24.
    Ikizler TA, Wingard RL, Harvell J, Shyr Y, Hakim RM (1999) Association of morbidity with markers of nutrition and inflammation in chronic hemodialysis patients: a prospective study. Kidney Int 55(5):1945–1951CrossRefPubMedGoogle Scholar
  25. 25.
    Myron Johnson A, Merlini G, Sheldon J, Ichihara K (2007) Clinical indications for plasma protein assays: transthyretin (prealbumin) in inflammation and malnutrition: International Federation of Clinical Chemistry and Laboratory Medicine (IFCC): IFCC Scientific Division Committee on Plasma Proteins (C-PP). Clin Chem Lab Med 45(3):419–426CrossRefPubMedGoogle Scholar

Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2018

Authors and Affiliations

  • Peter Olalekan Adeosun
    • 1
  • Olawunmi Adedoyin Fatusi
    • 2
  • Tewogbade Adeoye Adedeji
    • 3
  1. 1.Oral and Maxillofacial SurgeryObafemi Awolowo University Teaching HospitalIle-IfeNigeria
  2. 2.Oral and Maxillofacial Surgery, Faculty of Dentistry, College of Health SciencesObafemi Awolowo UniversityIle-IfeNigeria
  3. 3.Chemical Pathology, Faculty of Basic Medical Sciences, College of Health SciencesObafemi Awolowo UniversityIle-IfeNigeria

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