Complications from distant spread of orofacial infections: Frequency and effects on clinical and economic burden in the United States.

BACKGROUND

Distant spread of orofacial infections (OFIs) can cause severe complications. The authors aimed to estimate their frequency in the United States and to analyze patient- and hospital-level outcomes and contributors.

METHODS

In this retrospective cross-sectional study, the authors used the National Inpatient Sample database from 2020 through 2022 to query encounters related to OFIs. Study variables included occurrence of a severe complication from distant spread (DSC) (defined as cavernous sinus thrombosis, intracranial abscess, and mediastinitis), in-hospital mortality, hospital charges and length of stay (LOS), age, sex, insurance status, infection etiology, comorbidities, and hospital settings. Multivariable regression models were used to analyze the contributors of mortality, LOS, and charges.

RESULTS

In the 3-year period, there were 207,750 OFIs and 2,265 DSCs (1.1%), of which mediastinitis was the most common, followed by intracranial abscess and cavernous sinus thrombosis. Mean LOS was 5.8 days with OFIs and 19.7 days with DSC. Mortality rate was 1.2% with OFIs and 4.9% with DSCs. Mean charges were $72,823.00 per hospitalization. Results of regression analysis showed the presence of DSC and nonendodontic etiology to be the strongest predictors of mortality, hospital charges, and LOS (P < .05), among other factors.

CONCLUSIONS

The presence of DSC, infection etiology, and sociodemographic factors are associated with mortality, hospital charges, and LOS in OFIs.

PRACTICAL IMPLICATIONS: Understanding the contributing factors and complications due to disseminated OFI can help targeted efforts to improve clinical and health care outcomes.