Abstract
ObjectivesTo evaluate occurrence and risk factors for pneumonia in patients with deep odontogenic infection (OI).Materials and methodsAll patients treated for deep OIs and requiring intensive care and mechanical ventilation were included. The outcome variable was diagnosis of nosocomial pneumonia. Primary predictor variables were re-intubation and duration of mechanical ventilation. The secondary predictor variable was length of hospital stay (LOHS). The explanatory variables were gender, age, current smoking, current heavy alcohol and/or drug use, diabetes, and chronic pulmonary disease.ResultsNinety-two patients were included in the analyses. Pneumonia was detected in 14 patients (15%). It was diagnosed on postoperative day 2 to 6 (median 3 days, mean 3 days) after primary infection care. Duration of mechanical ventilation (p = 0.028) and LOHS (p = 0.002) correlated significantly with occurrence of pneumonia. In addition, re-intubation (p = 0.004) was found to be significantly associated with pneumonia; however, pneumonia was detected in 75% of these patients prior to re-intubation. Two patients (2%) died during intensive care unit stay, and both had diagnosed nosocomial pneumonia. Smoking correlated significantly with pneumonia (p = 0.011).ConclusionSecondary pneumonia due to deep OI is associated with prolonged hospital care and can predict the risk of death. Duration of mechanical ventilation should be reduced with prompt and adequate OI treatment, whenever possible. Smokers with deep OI have a significantly higher risk than non-smokers of developing pneumonia.Clinical relevanceNosocomial pneumonia is a considerable problem in OI patients with lengthy mechanical ventilation. Prompt and comprehensive OI care is required to reduce these risk factors.
Highlights
Hospitalized patients with odontogenic infections (OIs) are at risk for life-threatening conditions and infection complications
Clin Oral Invest (2021) 25:1925–1932 patient group are of respiratory origin [15], and as a nosocomial infection, the prevalence of ventilation-associated pneumonia (VAP) is 5–40% [16]
Patients who were treated in the oral and maxillofacial surgery’s emergency service for deep OI confirmed by oral and maxillofacial surgeons and required postoperative mechanical ventilation in the intensive care units (ICUs) were included in this study
Summary
Hospitalized patients with odontogenic infections (OIs) are at risk for life-threatening conditions and infection complications. These severe infections can lead to death despite accurate and multidisciplinary care [1,2,3]. Deep neck infection-associated pneumonia is reported to occur in 1–6% of hospitalized patients [2, 9, 14]. Patients’ general condition affects prognosis, and patients with reduced immune defence have associated respiratory tract infection secondary to OI more often than in other populations [2]. Pneumonia complicates patient care in intensive care units (ICUs) in general; nearly two-thirds (64%) of infections in this. Unplanned reintubation and emergency airway management predispose to these infections in general ICU patient populations
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