Is there need for technical investigations in order to predict potential length of hospital stay of oral infections?

OBJECTIVE: Oral and maxillofacial infections are generally treated by primary dental or medical caregivers. Nevertheless, because these infections are known to have life-threatening complications, there is a need of clear indicators for emergency services medical staff, particularly in determining when morbidity can be expected and when in-hospital treatment is required. This retrospective study aimed to identify variables that were observable at admission, which could indicate high complication rates, long hospital stays, and/or a need for tracheostomy.

MATERIALS AND METHODS: We examined data from all cases of severe oral and maxillofacial infections that were treated at the University Hospital of Leuven, between January 2013 and June 2017. 64 cases were identified after applying exclusion criteria. Uni- and multivariate analyses were performed.

RESULTS: A univariate analysis showed that body temperature, C-reactive protein (CRP) levels, white blood cell counts, and positive bacterial cultures were significantly associated with longer hospital stays, which indicated potential future morbidity. A multivariate analysis showed that dyspnoea, age, and CRP comprised the most significant combination for predicting the length of hospital stay.

CONCLUSION: Based on the statistical analysis of this population, the research group concludes that a thorough anamnesis and clinical examination should be accompanied by a blood analysis of CRP and white blood cell counts. Only then can a well-founded decision be reached on the severity of the case and the need for hospital admission. In an acute setting, radiological imaging is not required for assessing future morbidity, but it should be performed when accessible.