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Open AccessArticle

Five Predictors Affecting the Prognosis of Patients with Severe Odontogenic Infections

1
CHU Clermont-Ferrand, Inserm, Neuro-Dol, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
2
CHU Clermont-Ferrand, Délégation Recherche Clinique & Innovation, 63003 Clermont-Ferrand, France
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(23), 8917; https://doi.org/10.3390/ijerph17238917
Received: 28 October 2020 / Revised: 22 November 2020 / Accepted: 24 November 2020 / Published: 30 November 2020
(This article belongs to the Special Issue Research on Oral Health Outcomes)
Background: Dental cellulitis management is no longer a simple procedure, as more and more patients are needing long-time hospitalization, several surgeries and intensive care follow-up. This prospective study seeks to highlight criteria that can split patients with severe odontogenic infection into two groups: those with simple evolution and those for whom complex management is necessary. Methods: In this observational study, all patients considered with a severe odontogenic infection (which necessitated hospital admission, intravenous antibiotics and general anaesthesia) were enrolled between January 2004 and December 2014 from Clermont-Ferrand University Hospital (France). They were split into two groups: those who needed one surgical intervention with tooth extraction and collection drainage combined with probabilistic antibiotic to treat infection and those who need several surgeries, intensive care unit follow-up or tracheotomy to achieve healing. Results: 653 patients were included, of which 611 (94%) had one surgery, 42 (6%) had more than one surgery before healing. Penicillin allergy (p < 0.001), psychiatric disorders (p = 0.005), oropharyngeal oedema (p = 0.008), floor oedema (p = 0.004), fever (p = 0.04) and trismus (p = 0.018) on admission were the most relevant predictors of complex evolution. A conditional inference tree (CTREE) illustrated the association of prognostic factors and the need of multiple surgery. Conclusions: Besides clinical symptoms of severity, complications of severe odontogenic infection are predicted by measurables and objectives criteria as penicillin allergy, mandibular molar, C-reactive protein level, psychiatric disorders and alcohol abuse. Their specific association potentialize the risks. IRB number: CE-CIC-GREN-12-08. View Full-Text
Keywords: severe odontogenic infection; cellulitis; allergy; predictor severe odontogenic infection; cellulitis; allergy; predictor
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MDPI and ACS Style

Pham Dang, N.; Delbet-Dupas, C.; Mulliez, A.; Devoize, L.; Dallel, R.; Barthélémy, I. Five Predictors Affecting the Prognosis of Patients with Severe Odontogenic Infections. Int. J. Environ. Res. Public Health 2020, 17, 8917.

AMA Style

Pham Dang N, Delbet-Dupas C, Mulliez A, Devoize L, Dallel R, Barthélémy I. Five Predictors Affecting the Prognosis of Patients with Severe Odontogenic Infections. International Journal of Environmental Research and Public Health. 2020; 17(23):8917.

Chicago/Turabian Style

Pham Dang, Nathalie; Delbet-Dupas, Candice; Mulliez, Aurélien; Devoize, Laurent; Dallel, Radhouane; Barthélémy, Isabelle. 2020. "Five Predictors Affecting the Prognosis of Patients with Severe Odontogenic Infections" Int. J. Environ. Res. Public Health 17, no. 23: 8917.

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