Center of Stomatology, the Second Affiliated Hospital of Soochow University, No. 1055 Sanxiang Road, Suzhou, 215004, Jiangsu Province, People's Republic of China.
College of Dentistry, University of Illinois at Chicago, Chicago, IL, 60612, USA.
Ir J Med Sci. 2021 Aug;190(3):1045-1053. doi: 10.1007/s11845-020-02431-z. Epub 2020 Nov 14.
Maxillofacial space infection (MSI) experience review is beneficial for its management.
To identify potential risk factors predisposing to the exacerbation of MSI and a prolonged length of stay (LOS).
We performed a comprehensive retrospective review of medical records of 222 MSI patients admitted in Center of Stomatology during 1993-2019.
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).
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.
对颌面部间隙感染（MSI）的经验回顾有助于其管理。
确定易使 MSI 恶化和延长住院时间（LOS）的潜在危险因素。
我们对 1993 年至 2019 年期间在口腔中心住院的 222 例 MSI 患者的病历进行了全面回顾性分析。
约 63.5%的 222 例患者发生牙源性感染，下颌下间隙是最常受累的间隙。分离出的最常见病原体是链球菌属（72.4%）。多间隙病例比单间隙病例更易合并全身疾病、呼吸困难和危及生命的并发症，且表现出更差的临床特征（白细胞计数更高、体温更高、张口受限）（P<0.05）。多间隙病例和单间隙病例的 LOS 无显著差异。危及生命病例中糖尿病和高血压分别占 35.1%。多间隙感染（60.4%）、呼吸困难（11.7%）和全身状况（43.2%）被确定为 MSI 患者发生危及生命并发症的关键危险因素（P<0.001）。≥60 岁或合并全身疾病的患者 LOS 显著延长。与入院前自行治疗相比，2010-2019 年社区门诊治疗缩短了 1.9 天的 LOS（P<0.05）。
对于多间隙感染、呼吸困难和全身疾病的 MSI 患者，建议采用综合治疗方案，以避免扩散性恶化和发生危及生命的并发症。社区门诊治疗有利于缩短 LOS。提倡及时接受口腔门诊治疗，并同时稳定控制糖尿病和高血压。应强调提高医疗保险覆盖的口腔门诊治疗。
