Is there association between severe multispace infections of the oral maxillofacial region and diabetes mellitus?
OBJECTIVE
This study aims to identify the impact of diabetes on the final outcome (length of hospital stay and development of complications) in patients with severe multispace infections in the head and neck. Furthermore, it intends to characterize significant clinical features of these patients compared with nondiabetics.


METHODS
A retrospective study was conducted in 117 patients who received treatment for multispace infections of the head and neck region from 2007 through 2010 at the Department of Oral and Maxillofacial Surgery, Shanghai Ninth Hospital. The study identified diabetic patients and compared them with nondiabetic patients. Demographics, etiology of infection, clinical parameters (time from first onset of symptoms to hospital admission, number of spaces affected, and distribution of involved spaces), and laboratory values (bacteriology, admission blood glucose level, admission white blood cell count, and percentage of neutrophils on admission) were analyzed for clinical significance. Statistical analyses of the results between groups were performed using the Student t test, χ(2) test, variance analysis, logistic regression analysis, and linear regression analysis.


RESULTS
Admission blood glucose level was the only factor influencing the complications in multispace infections in the oral-maxillofacial region. Compared with nondiabetic patients, diabetics had infections that involved more spaces, longer hospital stays, and more frequent complications. Some diabetic patients died. The disease status (with or without diabetes) was associated with clinical outcomes (length of hospital stay and complications) in the therapy procedures.


CONCLUSIONS
This study identifies uncontrolled diabetes mellitus as an important indicator of clinical features and outcomes in treating multispace infections of the oral-maxillofacial region.
Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, School of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Lingyan
L
Zheng
Chi
C
Yang
Weijie
W
Zhang
Xieyi
X
Cai
Eric
E
Kim
Bin
B
Jiang
Baoli
B
Wang
Yiping
Y
Pu
Jin
J
Wang
Zhiyuan
Z
Zhang
Longnv
L
Zhou
Jian
J
Zhou
Xin
X
Guan
D000038:Abscess / Q000150:complications* / Q000382:microbiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D048909:Diabetes Complications / Q000097:blood / Q000382:microbiology; D004322:Drainage; D005260:Female; D005491:Focal Infection, Dental / Q000150:complications / Q000382:microbiology; D005500:Follow-Up Studies; D006257:Head; D006801:Humans; D007223:Infant; D007902:Length of Stay; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000473:pathology*; D009504:Neutrophils / Q000473:pathology; D010343:Patient Admission; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D001786:Blood Glucose