A nationwide survey of deaths from oral and maxillofacial infections: The Taiwanese experience

Abstract

Purpose: This study investigated the incidence of deaths from oral and maxillofacial infections encountered in a 3-year period. Patients and Methods: A survey was conducted nationwide. Questionnaires were constructed and sent to dental or OMS Departments of all medical centers, regional hospitals, and provincial and municipal hospitals in Taiwan. Only those infections severe enough for hospital care were studied. More than half of the departments replied, including all major hospitals. Results: A total of 2,790 cases were admitted to OMS or dental inpatient services because of oral and maxillofacial infections in the 3-year period. Eighteen deaths were reported by 9 departments during this period. The mortality rate in southern Taiwan was significantly higher than that in northern Taiwan ( P = .017). All deaths were in patients older than 40 years of age, and 66.7% had diabetes. In the 18 cases, there were deep neck infections (5 cases), necrotizing fasciitis (3 cases), Ludwig's angina (2 cases), brain abscess (2 cases), infected osteoradionecrosis (1 case), mucormycosis (1 case), buccal cellulitis (1 case), and unknown infection (3 cases). Sepsis was the most common cause of death. Conclusions: The estimated rate of death was approximately 1 in 150 cases admitted for oral and maxillofacial infections. Most of the patients who died were diabetics with deep or necrotizing infections. Particular attention should be paid to patients with these features.