Post-tooth extraction sepsis without locoregional infection--a population-based study in Taiwan.
OBJECTIVE
To investigate the incidence and risk factors of post-tooth extraction sepsis in patients without locoregional infection.


METHODS
We assessed all claim records of the Taiwanese National Health Insurance program in 2005. Admissions for patients aged > or =16 years containing a discharge diagnosis of sepsis, and who received tooth extraction within 14 days before the admission were identified. Patient charts were reviewed to confirm the diagnosis of sepsis and rule out other infection sources. The relationship between postextraction sepsis (PES) and clinical parameters was analyzed.


RESULTS
Thirty-three of the 2 223 971 extraction cases met the criteria of PES, an incidence of 1.48 per 100 000, and seven patients (21.2%) died of the disease. Aging significantly increased the risk of PES (P < 0.001). Pre-existing comorbidities were found in 20 of the 33 cases, with diabetes mellitus and hematologic diseases the most common. The method, number, and position of extraction had no influence on PES incidence. Blood cultures were positive in 25 patients (75.8%) and isolates included species of the Streptococcus, Actinomyces, Klebsiella, Bacteroides, Prevotella, and Enterococcus genera.


CONCLUSIONS
Tooth extraction is associated with a low but significant risk of postoperative sepsis, especially in the elderly and patients with underlying diseases.
Lee
J-J
JJ
School of Dentistry, National Taiwan University Medical Center, Taipei, Taiwan.
Hahn
L-J
LJ
Kao
T-P
TP
Liu
C-H
CH
Cheng
S-J
SJ
Cheng
S-L
SL
Chang
H-H
HH
Jeng
J-H
JH
Kok
S-H
SH
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005491:Focal Infection, Dental / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology*; D013530:Surgical Wound Infection / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology; D014081:Tooth Extraction / Q000009:adverse effects* / Q000706:statistics & numerical data; D055815:Young Adult