# Factors influencing recurrence after in-hospital treatment of odontogenic-related oromaxillofacial infections: a single-centre experience

## TL;DR

This study identifies factors like age, BMI, and specific clinical symptoms that increase the risk of infection recurrence and longer hospital stays after treating oromaxillofacial infections.

## Contribution

The study provides new insights into predictors of infection recurrence and hospital length of stay in odontogenic-related oromaxillofacial infections.

## Key findings

- Older age, higher BMI, and mandibular infections are linked to higher recurrence risk.
- Postoperative ICU stay increases recurrence risk by 9.13-fold.
- Elevated inflammatory markers and specific clinical symptoms at admission are associated with worse outcomes.

## Abstract

Evidence regarding specific factors influencing recurrence after treatment of oromaxillofacial infections is limited. This study aimed to evaluate the incidence and identify predictors of recurrence following in-hospital treatment. A secondary aim was to analyze associations between patient- and procedure-specific variables, treatment outcomes, and hospital length of stay (LOS), and to identify high-risk patients.

In this retrospective, single-center study, patients with odontogenic-related oromaxillofacial infections treated surgically or conservatively over a 4-year period were included. Demographic, clinical, radiological, and treatment data were analyzed. Multivariable analyses were performed to identify predictors of recurrence and LOS.

A total of 939 patients (mean age 44.66 ± 22.95 years) met the inclusion criteria. The recurrence rate was 5.01%, and the mean LOS was 3.55 ± 2.47 days. Increased age and BMI, mandibular infections, infections post-extraction or post-augmentation, clinical symptoms at admission (restricted mouth opening, dysphagia, non-palpable mandibular margin), elevated inflammatory markers (CRP, leukocytes, neutrophils, procalcitonin), and cervical drainage were significantly associated with higher recurrence risk and increased LOS (p < 0.05). A postoperative ICU stay increased the recurrence risk 9.13-fold.

Within the limitations of this study, the results suggest that older age, higher BMI, mandibular involvement, post-extraction or post-augmentation infections, specific clinical symptoms at admission (restricted mouth opening, dysphagia, non-palpable mandibular margin), elevated inflammatory markers, cervical drainage approaches, and stay in ICU are associated with both a higher risk of infection recurrence and increased hospital stay. Multiple bacterial strains and no continuous antibiotic therapy after discharge also indicated a higher risk of recurrence, while surgery under intubation anesthesia was linked to an increased length of stay only. These factors should be considered early in treatment planning to optimize outcomes.

Not applicable.