Bolos Otilia Cornelia, Sorca Bogdan-Valeriu, Rusu Laura-Cristina, Tapalaga Gianina
Department of Dental Aesthetics, Faculty of Dental Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Revolutiei Boulevard 9, 300041 Timisoara, Romania.
Department of Oral Pathology, Multidisciplinary Center for Research, Evaluation, Diagnosis, and Therapies in Oral Medicine, Faculty of Dental Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Revolutiei Boulevard 9, 300041 Timisoara, Romania.
Biomedicines. 2024 Nov 27;12(12):2712. doi: 10.3390/biomedicines12122712.
Odontogenic infections (OIs) can progress rapidly and may lead to severe systemic complications, especially in patients with underlying conditions like diabetes mellitus (DM). This study aims to evaluate the predictive value of inflammatory scores-quick Sequential Organ Failure Assessment (qSOFA), Systemic Immune-Inflammation Index (SII), derived Neutrophil-to-Lymphocyte Ratio (dNLR), and Odontogenic Infection Severity Score (OISS)-in assessing the severity of OIs in diabetic versus non-diabetic patients. A case-control study was conducted on 123 patients diagnosed with OIs. Patients were divided into two groups: patients with diabetes ( = 42) and patients who were non-diabetic ( = 81). Inflammatory scores were calculated at admission and correlated with clinical outcomes. Statistical analyses included -tests, chi-square tests, and multivariate logistic regression. The patients with diabetes exhibited significantly higher OISS scores (mean 6.5 ± 2.8) compared to the patients who were non-diabetic (mean 4.8 ± 2.1, < 0.001). The inflammatory markers qSOFA, SII, and dNLR were significantly elevated in the diabetic group (all < 0.01). The SII demonstrated the highest predictive accuracy for severe OIs in patients with diabetes, with an area under the curve (AUC) of 0.88 (95% CI: 0.80-0.95). Diabetes mellitus was an independent predictor of severe OIs (OR: 3.2, 95% CI: 1.5-6.8, = 0.003). Inflammatory scores, particularly SII, are effective in predicting the severity of odontogenic infections in patients with diabetes. Incorporating these scores into clinical practice may enhance the early identification of high-risk patients and improve management strategies.
牙源性感染（OIs）可迅速进展，并可能导致严重的全身并发症，尤其是在患有糖尿病（DM）等基础疾病的患者中。本研究旨在评估炎症评分——快速序贯器官衰竭评估（qSOFA）、全身免疫炎症指数（SII）、衍生中性粒细胞与淋巴细胞比值（dNLR）和牙源性感染严重程度评分（OISS）——在评估糖尿病患者与非糖尿病患者牙源性感染严重程度方面的预测价值。对123例诊断为牙源性感染的患者进行了病例对照研究。患者分为两组：糖尿病患者（n = 42）和非糖尿病患者（n = 81）。入院时计算炎症评分，并将其与临床结局相关联。统计分析包括t检验、卡方检验和多因素逻辑回归。与非糖尿病患者（平均4.8±2.1，P < 0.001）相比，糖尿病患者的OISS评分显著更高（平均6.5±2.8）。糖尿病组的炎症标志物qSOFA、SII和dNLR均显著升高（均P < 0.01）。SII对糖尿病患者严重牙源性感染的预测准确性最高，曲线下面积（AUC）为0.88（95%CI：0.80 - 0.95）。糖尿病是严重牙源性感染的独立预测因素（OR：3.2，95%CI：1.5 - 6.8，P = 0.003）。炎症评分，尤其是SII，可有效预测糖尿病患者牙源性感染的严重程度。将这些评分纳入临床实践可能会加强对高危患者的早期识别并改善管理策略。
