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Predictors of outcome in children hospitalized with maxillofacial infections: a linear logistic model
T B Dodson1, J A Barton, L B Kaban
1Department of Oral and Maxillofacial Surgery, School of Dentistry, University of California-San Francisco.
Insights
Predicting pediatric maxillofacial infection outcomes is possible using age, temperature, white blood cell count, and infection source. These factors help determine clinical outcomes for children with facial infections.
Area of Science:
- Pediatric Infectious Diseases
- Oral and Maxillofacial Surgery
- Clinical Epidemiology
Background:
- Maxillofacial infections in children can lead to severe complications.
- Predictive factors for clinical outcomes in pediatric maxillofacial infections require identification.
Purpose of the Study:
- To identify key variables predicting clinical outcomes in pediatric patients with maxillofacial infections.
- To develop and validate a predictive model for clinical outcomes.
Main Methods:
- Linear logistic regression analysis was employed.
- Patient data (n=105) from 1982-1986 at San Francisco General Hospital (SFGH) were retrospectively analyzed.
- A predictive model was developed using an index set and validated on separate validation sets.
Main Results:
- Age, admission temperature, admission white blood cell count, and infection source were significant predictors of clinical outcome.
- The validated model demonstrated reasonable accuracy in predicting unfavorable outcomes (length of hospital stay >= 4 days and/or need for surgery).
Conclusions:
- A predictive model incorporating age, temperature, white blood cell count, and infection source can aid in assessing clinical outcomes for pediatric maxillofacial infections.
- Early identification of high-risk patients can potentially improve management strategies and patient outcomes.
Abstract:
The purpose of this study was to determine factors predictive of clinical outcome for pediatric patients with maxillofacial infections. Using linear logistic regression, four important variables, age, admission temperature, admission white blood cell count, and source of infection, were identified. Relevant study variables were abstracted from the records of all children less than 15 years old admitted to San Francisco General Hospital (SFGH) with facial infections between 1982 and 1986 (n = 105). An unfavorable clinical outcome was defined as a length of hospital stay (LOS) greater than or equal to 4 days and/or the need for an operation to resolve the infection. A favorable outcome was a LOS less than 4 days and no operation. To develop and validate the linear logistic model, the original group of patients (n = 105) was divided into index and validation sets. The index set was created by randomly selecting 80 of the original patients. The model was then applied to a validation set of the 25 remaining children. The model predicted that 13.95 of the patients in the validation set would have an unfavorable outcome. The actual number of unfavorable outcomes was 16. To further test the model's validity, a third data set was collected. It was composed of pediatric patients admitted to SFGH between January 1, 1987 and June 30, 1989 (n = 24). The model predicted that 15.99 of these patients would have an unfavorable outcome; 17 patients actually did have an unfavorable outcome.(ABSTRACT TRUNCATED AT 250 WORDS)