• Yunzhu Qian, Qi Ge, Wei Zuo, Xi Cheng, Danlei Xing, Jianxin Yang, Maria Grace Costa Viana, and Phimon Atsawasuwan.
• Center of Stomatology, the Second Affiliated Hospital of Soochow University, No. 1055 Sanxiang Road, Suzhou, 215004, Jiangsu Province, People's Republic of China. yunzhu_qian@sina.com.
• Ir J Med Sci. 2021 Aug 1; 190 (3): 1045-1053.

BackgroundMaxillofacial space infection (MSI) experience review is beneficial for its management.AimTo identify potential risk factors predisposing to the exacerbation of MSI and a prolonged length of stay (LOS).MethodsWe performed a comprehensive retrospective review of medical records of 222 MSI patients admitted in Center of Stomatology during 1993-2019.ResultsAbout 63.5% of 222 patients had an odontogenic infection, and submandibular space was the most involved space. Streptococcus spp. was the most common organism isolated (72.4%). Multiple-space cases had more systemic diseases, respiratory difficulty, and life-threatening complications and exhibited worse clinical characteristics (higher white-blood-cell-count, higher body temperature, and restricted mouth opening) than single-space cases (P < 0.05). No significant difference in LOS was found between multiple-space cases and single-space cases. Diabetes and hypertension both accounted for 35.1% in life-threatening cases. Multiple-space infection (60.4%), respiratory difficulty (11.7%), and systemic conditions (43.2%) were identified as critical risk factors associated with life-threatening complications in MSI patients (P < 0.001). A significantly prolonged LOS was found in cases aged ≥ 60 years or with systemic diseases. Community outpatient treatment shortened 1.9 days of LOS compared with self-medication before admission during 2010-2019 (P < 0.05).ConclusionComprehensive managements are advisable for MSI patients with multiple-space infection, respiratory difficulty, systemic diseases to avoid disseminated exacerbation, and occurrence of life-threatening complications. Community outpatient treatment was beneficial to a reduced LOS. Timely access to dental outpatient management and simultaneously steady control of diabetes and hypertension was advocated. Improved coverage of insured dental outpatient treatment should be stressed.© 2020. Royal Academy of Medicine in Ireland.

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