Retrospective Study Of Oral And Maxillofacial Space Infection And Analysis Of Related Factors

Objectives:A retrospective study is to investigate the clinical characteristics of maxillofacial space infection,the risk factors associated with complications of maxillofacial space infection and the changes of both plasma D-dimer and Fibrinogen content in patients.Methods:1.704 cases of oral and maxillofacial space infections were recruited,retrospective analysis characteristics included demography(age,sex,occupation),etiology,spaces involved,treatment and complication.The univariate analysis and multivariate logistic linear regression were used to explore the risk factors for serious complications.2.Between October 2016 and March 2018,104 patients with maxillofacial space infection were divided into single-space infection group(67 cases)and multi-space infection group(37 cases)according to the number of space involved,125 patients with non-infectious diseases as control group.The blood D-dimer and fibrinogen were detected at 24 and 72 hours.Results:1.In 704 patients with MSI,the average age was(46.28±19.46)years.There are 427 males and 277 females.Among the 198 elderly patients(28.1%)over the age of 60,farmers had the highest incidence(49.2%).Dental infection is the most important cause,accounting for 56.5%.There were 518 cases(73.6%)with single space infection and 186 cases(26.4%)with multiple infections.Masseter muscle space is the most susceptible site in single-space infection,accounting for 29.3%.Upper airway obstruction is the most common complication.Univariate analysis showed that complications were more likely to occur in elderly farmers,concomitant systemic diseases,pre-admitted course of illness ≥7 days,leukocyte count ≥15×109/L,and multi-compartmental infections.Logistic regression multivariate analysis showed that farmers,concomitant systemic diseases,pre-admission course,leukocyte count≥15×109/L and multi-compartmental infection were independent risk factors for complications.2.At the time of admission,D-dimer and fibrinogen were significantly higher in the patients with single space group and multiple space group than those in the control group(P<0.05).The D-dimer and fibrinogen levels decreased at the treatment of 72h after admission,the difference was statistically significant(P<0.05)At 72 hours of treatment and discharge from hospital,the D-dimer and fibrinogen levels of the two groups of infected patients were lower than those at admission(P<0.05).There was no significant difference in the levels of D-dimer and FIB between the two groups of infected patients at discharge(P>0.05).Conclusions:1.The population of patients with oral and maxillofacial space infections is mainly farmers,especially those over 60 years old.The odontogenic infection is the main cause,and the masseter space and submandibular space are easy to be involved.Multivariate analysis showed farmer,systemic disease,white blood cell count ≥15×109/L and multi-space infection were independent risk factors for complications.2.The D-dimer and fibrinogen levels in patients with oral and maxillofacial space infection were significantly elevated,,suggesting that patients with maxillofacial interstitial infection have different degrees of abnormal coagulation and fibrinolytic function.Proper use of anticoagulant drugs may become an adjunct to treatment.