Sakkas Andreas, Rana Majeed, Scheurer Mario, Kasper Robin, Ebeling Marcel, Wilde Frank, Schramm Alisa, Engelbrecht Jasmin
Department of Oral and Maxillofacial Surgery, University Hospital Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany.
Department of Oral and Plastic Maxillofacial Surgery, Military Hospital Ulm, Ulm, Germany.
BMC Oral Health. 2025 Jul 28;25(1):1273. doi: 10.1186/s12903-025-06662-3.
Evidence regarding specific factors influencing recurrence after treatment of oromaxillofacial infections is limited. This study aimed to evaluate the incidence and identify predictors of recurrence following in-hospital treatment. A secondary aim was to analyze associations between patient- and procedure-specific variables, treatment outcomes, and hospital length of stay (LOS), and to identify high-risk patients.
In this retrospective, single-center study, patients with odontogenic-related oromaxillofacial infections treated surgically or conservatively over a 4-year period were included. Demographic, clinical, radiological, and treatment data were analyzed. Multivariable analyses were performed to identify predictors of recurrence and LOS.
A total of 939 patients (mean age 44.66 ± 22.95 years) met the inclusion criteria. The recurrence rate was 5.01%, and the mean LOS was 3.55 ± 2.47 days. Increased age and BMI, mandibular infections, infections post-extraction or post-augmentation, clinical symptoms at admission (restricted mouth opening, dysphagia, non-palpable mandibular margin), elevated inflammatory markers (CRP, leukocytes, neutrophils, procalcitonin), and cervical drainage were significantly associated with higher recurrence risk and increased LOS (p < 0.05). A postoperative ICU stay increased the recurrence risk 9.13-fold.
Within the limitations of this study, the results suggest that older age, higher BMI, mandibular involvement, post-extraction or post-augmentation infections, specific clinical symptoms at admission (restricted mouth opening, dysphagia, non-palpable mandibular margin), elevated inflammatory markers, cervical drainage approaches, and stay in ICU are associated with both a higher risk of infection recurrence and increased hospital stay. Multiple bacterial strains and no continuous antibiotic therapy after discharge also indicated a higher risk of recurrence, while surgery under intubation anesthesia was linked to an increased length of stay only. These factors should be considered early in treatment planning to optimize outcomes.
Not applicable.
关于影响口腔颌面部感染治疗后复发的特定因素的证据有限。本研究旨在评估住院治疗后复发的发生率并确定复发的预测因素。次要目的是分析患者和手术相关变量、治疗结果与住院时间（LOS）之间的关联，并识别高危患者。
在这项回顾性单中心研究中，纳入了在4年期间接受手术或保守治疗的牙源性相关口腔颌面部感染患者。分析了人口统计学、临床、放射学和治疗数据。进行多变量分析以确定复发和住院时间的预测因素。
共有939例患者（平均年龄44.66±22.95岁）符合纳入标准。复发率为5.01%，平均住院时间为3.55±2.47天。年龄和体重指数增加、下颌感染、拔牙或种植后感染、入院时的临床症状（张口受限、吞咽困难、下颌边缘不可触及）、炎症标志物升高（CRP、白细胞、中性粒细胞、降钙素原）以及颈部引流与较高的复发风险和住院时间延长显著相关（p<0.05）。术后入住重症监护病房使复发风险增加9.13倍。
在本研究的局限性内，结果表明年龄较大、体重指数较高、下颌受累、拔牙或种植后感染、入院时的特定临床症状（张口受限、吞咽困难、下颌边缘不可触及）、炎症标志物升高、颈部引流方法以及入住重症监护病房与感染复发风险较高和住院时间延长均相关。多种细菌菌株以及出院后无持续抗生素治疗也表明复发风险较高，而插管麻醉下手术仅与住院时间延长有关。在治疗计划的早期应考虑这些因素以优化治疗结果。
不适用。
