| Objectives:We analyzed the pathogenesis of Oral and Maxillofacial Space Infection(OMSI),explored the risk factors of Life-threatening Oral and Maxillofacial Space Infection(LTOMSI),and developed a predictive model for the prevention and treatment of LTOMSI.To investigate the risk factors of life-threatening oral and maxillofacial space infections(LTOMSI)and to develop predictive models for the prevention and treatment of LTOMSI.Research Methodology:The medical records of all OMSI patients admitted to Shengjing Hospital of China Medical University from January 2018 to July 2022 were collected.Firstly,patients were randomly divided into two groups in the ratio of 8:2,one group was used as the training set to construct the risk prediction model(Nomogram model),and the other group was used as the validation set to verify the prediction model,while the ROC curve was used to evaluate the model performance.Patients in the training set were then divided into LTOMSI and non-LTOMSI groups according to whether they were LTOMSI or not,and single-factor logistic regression and multi-factor logistic regression analyses were performed using R language on variables such as age,sex,cause of infection,location of infection,type of infected gap and laboratory tests to screen out independent risk factors for life-threatening maxillofacial gap infections.The screened independent risk factors were subsequently used to build a risk prediction model,and finally the accuracy of the model was verified by using patients from the validation set.Results:A total of 136 patients were screened for inclusion in this study according to the inclusion and exclusion criteria based on our electronic medical record system query OMSI,and were randomly divided into two groups according to the ratio of 8:2,with109 patients in the training set and 27 patients in the validation set.The minimum age of all included patients was 2 years and the maximum age was 90 years,99 were male and37 were female.Eighty-one patients(59.6%)were included in the non-LTOMSI group and 55 patients(40.4%)were included in the LTOMSI group.The information of patients in the training set was analyzed by univariate logistic regression and found that history of alcohol consumption,history of diabetes,time from onset to presentation,presence of dyspnea at presentation,location of onset in the cheek or neck,C-reactive protein(CRP),blood glucose(Glu),infection spreading to the parapharyngeal space,submandibular space,subchin space,sublingual space,soft tissue space of the neck or chest cavity,presence of pus at the site of infection or air,and Narrowing of the airway was an associated risk factor for the development of LTOMSI(P<0.05).After multifactorial logistic regression analysis,it was found that the presence of dyspnea at the time of consultation,narrowing of the airway,and the spread of infection to the chest cavity were independent risk factors for the development of LTOMSI(P<0.05).The P values for infection spread to the parapharyngeal space and the presence of pus or gas at the infection site were close to 0.05,P=0.054 and P=0.062,respectively,indicating that they may also be risk factors strongly associated with the occurrence of LTOMSI.Finally,after several attempts,it was found that the prediction model constructed by putting the above five risk factors,namely: dyspnea at presentation,narrowing of the airway,infection spreading to the chest cavity,infection spreading to the parapharyngeal space,and pus or gas production at the site of infection,into the prediction model was the most accurate.Conclusions: The presence of dyspnea,narrowing of the airway,infection spreading to the chest,infection spreading to the parapharyngeal space,and pus or gas production at the site of infection are the most important risk factors for LTOMSI in patients at the time of consultation,and the prediction model we constructed using them can effectively predict the probability of LTOMSI,thus helping clinicians to make better and faster decisions. |
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