Factors associated with treatment outcomes of patients hospitalized with severe maxillofacial infections at a tertiary center
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Objectives: The purpose of this retrospective study was to evaluate the variables associated with length of stay (LOS), hospital costs, intensive care unit (ICU) use, and treatment outcomes in patients hospitalized for maxillofacial infections at a tertiary medical center in South Korea. Materials and Methods: A retrospective chart review was conducted for patients admitted for treatment of maxillofacial infections at Dankook University Hospital from January 1, 2011 through September 30, 2020. A total of 390 patient charts were reviewed and included in the final statistical analyses. Results: Average LOS and hospital bill per patient of this study was 11.47 days, and ₩4,710,017.25 ($4,216.67), respectively. Of the 390 subjects, 97.3% were discharged routinely following complete recovery, 1.0% expired following treatment, and 0.8% were transferred to another hospital. In multivariate linear regression analyses to determine variables associated with LOS, admission year, infection side, Flynn score, deep neck infection, cardiovascular disease, admission C-reactive protein (CRP) and glucose levels, number and length of surgical interventions, tracheostomy, time elapsed from admission to first surgery, and length of ICU stay accounted for 85.8% of the variation. With regard to the total hospital bill, significantly associated variables were age, type of insurance, Flynn score, number of comorbidities, admission CRP, white blood cell, and glucose levels, admission temperature, peak temperature, surgical intervention, the length, type, and location of surgery, tracheostomy, time elapsed from admission to first surgery, and length of ICU use, which accounted for 90.4% of the variation. Age and ICU use were the only variables significantly associated with unfavorable discharge outcomes in multivariate logistic regression analysis. Conclusion: For successful and cost-effective management of maxillofacial infections, clinicians to be vigilant about the decision to admit patients with maxillofacial infections, perform appropriate surgery at an adequate time, and admit them to the ICU.
Abstract
Objectives: The purpose of this retrospective study was to evaluate the variables associated with length of stay (LOS), hospital costs, intensive care unit (ICU) use, and treatment outcomes in patients hospitalized for maxillofacial infections at a tertiary medical center in South Korea. Materials and Methods: A retrospective chart review was conducted for patients admitted for treatment of maxillofacial infections at Dankook University Hospital from January 1, 2011 through September 30, 2020. A total of 390 patient charts were reviewed and included in the final statistical analyses. Results: Average LOS and hospital bill per patient of this study was 11.47 days, and ₩4,710,017.25 ($4,216.67), respectively. Of the 390 subjects, 97.3% were discharged routinely following complete recovery, 1.0% expired following treatment, and 0.8% were transferred to another hospital. In multivariate linear regression analyses to determine variables associated with LOS, admission year, infection side, Flynn score, deep neck infection, cardiovascular disease, admission C-reactive protein (CRP) and glucose levels, number and length of surgical interventions, tracheostomy, time elapsed from admission to first surgery, and length of ICU stay accounted for 85.8% of the variation. With regard to the total hospital bill, significantly associated variables were age, type of insurance, Flynn score, number of comorbidities, admission CRP, white blood cell, and glucose levels, admission temperature, peak temperature, surgical intervention, the length, type, and location of surgery, tracheostomy, time elapsed from admission to first surgery, and length of ICU use, which accounted for 90.4% of the variation. Age and ICU use were the only variables significantly associated with unfavorable discharge outcomes in multivariate logistic regression analysis. Conclusion: For successful and cost-effective management of maxillofacial infections, clinicians to be vigilant about the decision to admit patients with maxillofacial infections, perform appropriate surgery at an adequate time, and admit them to the ICU.
참고문헌 (28)
- Shelly Abramowicz, "The Burden of Facial Cellulitis Leading to Inpatient Hospitalization", Journal of Oral and Maxillofacial Surgery, 75(8), pp.1656~1667 (2017), Elsevier BV[DOI]
- Lindsay Eisler, "Morbidity and Cost of Odontogenic Infections", Otolaryngology–Head and Neck Surgery, 149(1), pp.84~88 (2013), SAGE Publications[DOI]
- Brian Christensen, "The Cause of Cost in the Management of Odontogenic Infections 2: Multivariate Outcome Analyses", Journal of Oral and Maxillofacial Surgery, 71(12), pp.2068~2076 (2013), Elsevier BV[DOI]
- Thomas R. Flynn, "Severe Odontogenic Infections, Part 1: Prospective Report", Journal of Oral and Maxillofacial Surgery, 64(7), pp.1093~1103 (2006), Elsevier BV[DOI]
- Kevin Gams, "Characteristics, length of stay, and hospital bills associated with severe odontogenic infections in Houston, TX", The Journal of the American Dental Association, 148(4), pp.221~229 (2017), Elsevier BV[DOI]
- Nazir Ahmad, "The Financial Burden of Hospitalization Associated With Odontogenic Infections", Journal of Oral and Maxillofacial Surgery, 71(4), pp.656~658 (2013), Elsevier BV[DOI]
- RH Hurley, "The hidden cost of deep neck space infections", The Annals of The Royal College of Surgeons of England, 100(2), pp.129~134 (2018), Royal College of Surgeons of England[DOI]
- Veerasathpurush Allareddy, "Longitudinal discharge trends and outcomes after hospitalization for mouth cellulitis and Ludwig angina", Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 118(5), pp.524~531 (2014), Elsevier BV[DOI]
- Jonathon S. Jundt, "Characteristics and cost impact of severe odontogenic infections", Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 114(5), pp.558~566 (2012), Elsevier BV[DOI]
- Andrea C. Shah, "Outcomes of Hospitalizations Attributed to Periapical Abscess from 2000 to 2008: A Longitudinal Trend Analysis", Journal of Endodontics, 39(9), pp.1104~1110 (2013), Elsevier BV[DOI]
- Min Kyeong Kim, "Burden of facial cellulitis: estimates from the Nationwide Emergency Department Sample", Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 114(3), pp.312~317 (2012), Elsevier BV[DOI]
- Min Kyeong Kim, "Factors associated with length of stay and hospital charges for patients hospitalized with mouth cellulitis", Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 113(1), pp.21~28 (2012), Elsevier BV[DOI]
- Pornchai Jansisyanont, "Factors related to the treatment outcome of maxillofacial fascia space infection", Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology, 27(4), pp.458~464 (2015), Elsevier BV[DOI]
- Chunxu Zhang, "Maxillofacial space infection experience in West China: a retrospective study of 212 cases", International Journal of Infectious Diseases, 14(5), pp.e414~e417 (2010), Elsevier BV[DOI]
- George C. Mathew, "Odontogenic maxillofacial space infections at a tertiary care center in North India: a five-year retrospective study", International Journal of Infectious Diseases, 16(4), pp.e296~e302 (2012), Elsevier BV[DOI]
- Ching Ching Yew, "Orofacial infection and influencing factors on prolonged hospital stay: A four year retrospective study of 207 cases", Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology, 33(1), pp.7~12 (2021), Elsevier BV[DOI]
- 박진영, "A retrospective analysis of risk factors of oromaxillofacial infection in patients presenting to a hospital emergency ward", Maxillofacial Plastic Reconstructive Surgery, 41(11), pp.1~8 (2019), 대한악안면성형재건외과학회[DOI]
- A.K. Agarwal, "Role of socioeconomic factors in deep neck abscess: A prospective study of 120 patients", British Journal of Oral and Maxillofacial Surgery, 45(7), pp.553~555 (2007), Elsevier BV[DOI]
- OECD, "Health at a glance 2019: OECD indicators" (2019), OECD Publishing
- Lingyan Zheng, "Is There Association Between Severe Multispace Infections of the Oral Maxillofacial Region and Diabetes Mellitus?", Journal of Oral and Maxillofacial Surgery, 70(7), pp.1565~1572 (2012), Elsevier BV[DOI]
- 장종원, "Analysis of glycosylated hemoglobin (HbA1c) level on maxillofacial fascial space infection in diabetic patients", 대한구강악안면외과학회지, 41(5), pp.251~258 (2015), 대한구강악안면외과학회
- 강신광, "Clinical Features of Deep Neck Infections and Predisposing Factors for Mediastinal Extension", Journal of Chest Surgery, 45(3), pp.171~176 (2012), 대한흉부외과학회[DOI]
- Brian Christensen, "The Cause of Cost in the Management of Odontogenic Infections 1: A Demographic Survey and Multivariate Analysis", Journal of Oral and Maxillofacial Surgery, 71(12), pp.2058~2067 (2013), Elsevier BV[DOI]
- Minsung Sohn, "Effects of public and private health insurance on medical service utilization in the National Health Insurance System: National panel study in the Republic of Korea", BMC Health Services Research, 16(1) (2016), Springer Science and Business Media LLC[DOI]
- Song YJ, "The South Korean health care system", JMAJ, 52, pp.206~209 (2009)
- OECD, "OECD Reviews of public health" (2020), OECD
- Estie Kruger, "Socioeconomic disadvantage and oral-health-related hospital admissions: a 10-year analysis", BDJ Open, 2(1) (2016), Springer Science and Business Media LLC[DOI]
- Thomas R. Flynn, "Severe Odontogenic Infections, Part 2: Prospective Outcomes Study", Journal of Oral and Maxillofacial Surgery, 64(7), pp.1104~1113 (2006), Elsevier BV[DOI]