Tarle Marko, Raguž Marina, Lukšić Ivica
Department of Maxillofacial Surgery, Dubrava University Hospital, 10000 Zagreb, Croatia.
School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia.
Diagnostics (Basel). 2024 Sep 28;14(19):2163. doi: 10.3390/diagnostics14192163.
Odontogenic abscesses are a common cause of emergency visits to oral and maxillofacial surgery departments and can lead to life-threatening complications if they are not recognized and treated promptly. The aim of this study was to evaluate the prognostic value of the Aggregate Index of Systemic Inflammation (AISI) in comparison to other systemic inflammatory indices, including the Systemic Immune Inflammation Index (SII), the Neutrophil-to-Lymphocyte Ratio (NLR), the Platelet-to-Lymphocyte Ratio (PLR), and the Lymphocyte-to-Monocyte Ratio (LMR), in predicting the severity of odontogenic abscesses. This retrospective study included 221 patients hospitalized for odontogenic abscesses at Dubrava University Hospital between January 2019 and December 2023. Clinical and laboratory data, including AISI, SII, NLR, PLR, and LMR, were collected. The severity of the abscesses was assessed using the Symptom Severity (SS) Score and patients were categorized into less severe and severe groups based on their scores. An ROC curve analysis was used to assess the predictive accuracy of each inflammatory index. The AISI was identified as the most effective predictor of abscess severity and had the highest sensitivity (SE = 82.93) and specificity (SP = 81.63) among the indices analyzed. It outperformed C-reactive protein (CRP) in predicting severe abscesses with an AUC of 0.90 compared to 0.74 for CRP. In addition, AISI showed significant correlations with length of hospital stay and the occurrence of systemic inflammatory response syndrome (SIRS). The AISI index is a better predictor of odontogenic abscess severity compared to other systemic inflammatory markers and CRP. Its integration into clinical practice could improve the early detection of high-risk patients, leading to better treatment outcomes and lower risks of complications.
牙源性脓肿是口腔颌面外科急诊就诊的常见原因，如果不及时识别和治疗，可能会导致危及生命的并发症。本研究的目的是评估全身炎症综合指数（AISI）与其他全身炎症指标相比的预后价值，这些指标包括全身免疫炎症指数（SII）、中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）以及淋巴细胞与单核细胞比值（LMR），用于预测牙源性脓肿的严重程度。这项回顾性研究纳入了2019年1月至2023年12月期间在杜布拉瓦大学医院因牙源性脓肿住院的221例患者。收集了包括AISI、SII、NLR、PLR和LMR在内的临床和实验室数据。使用症状严重程度（SS）评分评估脓肿的严重程度，并根据评分将患者分为轻度和重度组。采用ROC曲线分析评估每个炎症指标的预测准确性。AISI被确定为脓肿严重程度的最有效预测指标，在所分析的指标中具有最高的敏感性（SE = 82.93）和特异性（SP = 81.63）。在预测严重脓肿方面，AISI的表现优于C反应蛋白（CRP），其AUC为0.90，而CRP为0.74。此外，AISI与住院时间和全身炎症反应综合征（SIRS）的发生显著相关。与其他全身炎症标志物和CRP相比，AISI指数是牙源性脓肿严重程度的更好预测指标。将其纳入临床实践可以改善高危患者的早期检测，从而带来更好的治疗效果和更低的并发症风险。
