• Niina Rautaporras, Jussi Furuholm, Johanna Uittamo, Mikko Saloniemi, Tuukka Puolakka, and Johanna Snäll.
• Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, P.O. Box 220, (Haartmaninkatu 4E), FI-00029 HUH, Helsinki, Finland. niina.rautaporras@helsinki.fi.
• Clin Oral Investig. 2021 Apr 1; 25 (4): 1925-1932.

ObjectivesTo evaluate occurrence and risk factors for pneumonia in patients with deep odontogenic infection (OI).Materials And MethodsAll patients treated for deep OIs and requiring intensive care and mechanical ventilation were included. The outcome variable was diagnosis of nosocomial pneumonia. Primary predictor variables were re-intubation and duration of mechanical ventilation. The secondary predictor variable was length of hospital stay (LOHS). The explanatory variables were gender, age, current smoking, current heavy alcohol and/or drug use, diabetes, and chronic pulmonary disease.ResultsNinety-two patients were included in the analyses. Pneumonia was detected in 14 patients (15%). It was diagnosed on postoperative day 2 to 6 (median 3 days, mean 3 days) after primary infection care. Duration of mechanical ventilation (p = 0.028) and LOHS (p = 0.002) correlated significantly with occurrence of pneumonia. In addition, re-intubation (p = 0.004) was found to be significantly associated with pneumonia; however, pneumonia was detected in 75% of these patients prior to re-intubation. Two patients (2%) died during intensive care unit stay, and both had diagnosed nosocomial pneumonia. Smoking correlated significantly with pneumonia (p = 0.011).ConclusionSecondary pneumonia due to deep OI is associated with prolonged hospital care and can predict the risk of death. Duration of mechanical ventilation should be reduced with prompt and adequate OI treatment, whenever possible. Smokers with deep OI have a significantly higher risk than non-smokers of developing pneumonia.Clinical RelevanceNosocomial pneumonia is a considerable problem in OI patients with lengthy mechanical ventilation. Prompt and comprehensive OI care is required to reduce these risk factors.

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