Maxillofacial space infection experience in West China: a retrospective study of 212 cases
Objectives: Our objectives were to analyze the clinical features of maxillofacial space infection (MSI) patients admitted to the West China Hospital of Stomatology over a five-year period, and to identify potential risk factors associated with life-threatening complications. Methods: A retrospective medical chart review was performed and the sociodemographic and clinical characteristics of patients with MSI were evaluated. Results: A total of 212 patients were enrolled in this study, including 125 males (59.0%) and 87 females (41.0%), with an age range of 1-88 years (median 47.5 years). The most common cause of MSI was odontogenic infection (56.1%). The submandibular space was the space most commonly involved in both single space and multiple space infections (37.5% and 29.1%, respectively). One hundred and two patients (48.1%) self-medicated before admission, and the time from onset of symptoms until presentation was longer in those who self-medicated compared with those who did not (p=0.028). Fifty-seven patients (26.9%) had life-threatening complications and six died (2.8%). In multivariate analysis, age, self-medication, admission temperature, respiratory difficulty, and underlying diseases were found to be risk factors for life-threatening complications. The most common occupation of the patients was farmer (54.7%). Among the farmers, 72.4% had an odontogenic etiology; however, 91.7% of the farmers with odontogenic space infections had not undergone dental treatment before admission. Conclusions: Our experience suggests that the management of MSI should be more aggressive when the above risk factors are present, in order to avoid life-threatening complications. In addition, considering the poor medical conditions in the rural areas of West China, standard dental care and services should be provided in the future to replace self-medication.
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