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Risk Factors for Maxillofacial Space Infection Complications: A Retrospective Analysis of 457 Patients
1Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology.
Abstract:
This study was performed to determine the risk factors associated with systemic complications of maxillofacial space infection (MSI), and to propose an objective evaluation index - severity score of MSI. 457 MSI patients from Jan 2010 to Dec 2020 were reviewed retrospectively. The predictor variables included demographic, origin of infection, underlying systemic disease, pre-hospital medication history, laboratory examinations and severity scores of space infection. The severity score of space infection was proposed to evaluate the airway compromise of anatomic spaces. The primary outcome variable was the complication. The impact factors of complications were analyzed using univariate analysis and multivariate logistic regression. 457 patients were included (average age 46.3 y, male to female ratio 1.43:1). Among them, 39 patients developed postoperative complications. In the complication group, there were 18 patients (46.2%) with pulmonary infection, and two patients died. We found that the history of diabetes mellitus (OR=4.74, 95% confidence interval (CI)=2.22, 10.12), high temperature (≥39°C) (OR=4.16, 95% CI=1.43, 12.06), advanced age (≥65 y) (OR=2.88, 95% CI=1.37, 6.01), and severity score of space infection (OR=1.14, 95% CI=1.04, 1.25) were independent risk factors for complications of MSI. All the risk factors needed to be closely monitored. Severity score of MSI was an objective evaluation index to predict complications.
Insights
Systemic complications of maxillofacial space infection (MSI) are linked to diabetes, high fever, older age, and a high MSI severity score. These factors require monitoring for better patient outcomes.
Area of Science:
- Medical Research
- Infectious Diseases
- Surgical Complications
Background:
- Maxillofacial space infections (MSI) can lead to severe systemic complications.
- Identifying risk factors and developing predictive tools for MSI complications is crucial.
Purpose of the Study:
- To determine risk factors for systemic complications in maxillofacial space infections (MSI).
- To propose an objective evaluation index, the severity score of MSI, for predicting complications.
Main Methods:
- Retrospective review of 457 MSI patients (Jan 2010-Dec 2020).
- Analysis of demographic data, infection origin, comorbidities, medication history, lab results, and MSI severity scores.
- Univariate and multivariate logistic regression to identify independent risk factors for complications.
Main Results:
- 39 out of 457 patients developed postoperative complications, including pulmonary infection (46.2%) and mortality (2 patients).
- Independent risk factors for complications included history of diabetes mellitus (OR=4.74), high temperature ≥39°C (OR=4.16), advanced age ≥65 years (OR=2.88), and MSI severity score (OR=1.14).
Conclusions:
- Diabetes mellitus, high fever, advanced age, and MSI severity score are significant independent risk factors for systemic complications.
- The proposed severity score of MSI serves as an objective index for predicting complications and warrants close monitoring.
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