Is Postoperative Steroid Use Associated With Improved Outcomes in Severe Odontogenic Infections?

Background: The use of steroids as an adjunctive therapy in odontogenic infections is common, but few studies have focused on the effect of steroids in improving outcomes in these infections.

Purpose: The purpose of the study was to measure the association between postoperative steroid use and length of stay (LOS) and reoperation among patients with severe odontogenic infections.

Study design, setting, sample: The authors conducted a prospective cohort study consisting of all adult patients treated in the operating room for an odontogenic infection from August 1, 2019, to December 31, 2022, at University Medical Center of New Orleans. Patients were excluded if an odontogenic source could not be confirmed.

Predictor variable: The predictor variable was the use of steroids postoperatively (after conclusion of surgery until discharge), coded as a yes or no.

Main outcome variable: The outcome variables were total LOS, postsurgical LOS, and reoperation.

Covariates: The covariates were demographics, medical history, exam findings, diagnosis, and treatment-related variables.

Analyses: Descriptive and bivariate analyses were performed, as well as linear regression analyses. A P value of ≤ .05 was considered significant.

Results: The study sample consisted of 240 patients with a mean age of 40.3 ± 14.5 years and a sex distribution of 57.5% (138) male and 42.5% (102) female. Steroids were used in 114 patients (47.5%) postoperatively. The mean total LOS and postsurgical LOS were 3.7 ± 2.4 days and 3.1 ± 2.4 days, respectively. Reoperation was performed for 12 (5.0%) patients. Postoperative steroid use group was not significantly associated with total LOS (3.7 ± 2.6 days vs 3.6 ± 2.2 days, P = .59), postsurgical LOS (3.3 ± 2.6 days vs 2.9 ± 2.1 days, P = .13), or reoperation (58.3 vs 41.7%, P = .56) for the group that received steroids versus those that did not, respectively.

Conclusions and relevance: Postoperative steroid use was not associated with reduced LOS, postsurgical LOS, or reoperation in patients with severe odontogenic infections.