Kim Hye-Won, Kim Chul-Hwan
Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Cheonan, Korea.
J Korean Assoc Oral Maxillofac Surg. 2021 Jun 30;47(3):197-208. doi: 10.5125/jkaoms.2021.47.3.197.
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.
: 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.
: 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.
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.
本回顾性研究旨在评估韩国一家三级医疗中心因颌面部感染住院患者的住院时间（LOS）、医院费用、重症监护病房（ICU）使用情况及治疗结果相关变量。
对2011年1月1日至2020年9月30日在韩国檀国大学医院因颌面部感染入院治疗的患者进行回顾性病历审查。共审查了390份患者病历并纳入最终统计分析。
本研究中每位患者的平均住院时间和医院账单分别为11.47天和4,710,017.25韩元（4,216.67美元）。在390名受试者中，97.3%在完全康复后常规出院，1.0%在治疗后死亡，0.8%转至其他医院。在多因素线性回归分析中确定与住院时间相关的变量时，入院年份、感染部位、弗林评分、颈部深部感染、心血管疾病、入院时C反应蛋白（CRP）和血糖水平、手术干预的次数和时长、气管切开术、入院至首次手术的时间以及ICU住院时长占变异的85.8%。关于医院总账单，显著相关变量为年龄、保险类型、弗林评分、合并症数量、入院CRP、白细胞和血糖水平、入院体温、最高体温、手术干预、手术的时长、类型和部位、气管切开术、入院至首次手术的时间以及ICU使用时长，这些变量占变异的90.4%。在多因素逻辑回归分析中，年龄和ICU使用是与不良出院结局显著相关的仅有的变量。
为成功且经济高效地管理颌面部感染，临床医生在决定收治颌面部感染患者时应保持警惕，在适当时间进行恰当手术，并将患者收入ICU。
