TITLE:
Severity Score as a Prognostic Factor for Management of Infections of Odontogenic Origin, a Study of 100 Cases
AUTHORS:
Roman Mirochnik, Shareef Araidy, Victoria Yaffe, Imad Abu El-Naaj
KEYWORDS:
CRP, Odontogenic Infection, Dental Abscess, C-Reactive Protein
JOURNAL NAME:
Open Journal of Stomatology,
Vol.7 No.1,
January
6,
2017
ABSTRACT: Purpose: The main objective of
the current study is to determine whether it is possible to correlate the
longevity of the hospitalization period (LOS) to efficacy of surgical treatment
regime and severity scoring. Materials and Methods: A total of 100
patients met our inclusion criteria. All patient records, including results of
hematologic and biochemical parameters, were recorded. The patients were later
subcategorized further according to a severity score (“Low, Moderate, Severe”)
of their main facial space involvement. The main analysis of the study is a
regression analysis model; all the variables (sex, age, CRP, white blood cell
count, fever, space, and etiology) were stratified according to the overall
hospital stay. A crosstab comparison was performed next; the variables were
categorized and combined with hospital stay, and then entered in Spearman’s rank correlation coefficient or Spearman’s rho (ρ), 2-tailed (t) Test,
and regression equation. The significance level was set at p Results: The most prevalent anatomical space infection was vestibular space abscess
or cellulitis 33%, followed by an infraorbital space abscess or cellulitis 17%. Most commonly involved teeth are lower molars with 43% of the total,
upper central sixth with 20% and upper molars with 10%; mandibular origin was found to be the cause in 54%. The regression
equation showed no linear relation between CRP with the overall hospital stay (p > 0.05). No systemic temperature values were found to be correlated to
any space involved or LOS. Log-rank chi-square effect tests indicated only a significant effect of
severity, p =0.00016. The “Moderate & Severe” group compared to the “Low” group had a longer median LOS, 4.5 (2
to 8) vs 3 (1 to 8) respectively. Conclusion: The findings of this study
have shown severity scoring to be statistically significant parameter in LOS
prediction.