深颈部感染患者使用义齿临床意义的多学科分析。

IF 0.7
Tsai-Fu Lee, Chia-Ying Ho, Yu-Chien Wang, Shy-Chyi Chin, Kai-Chieh Chan, Shih-Lung Chen
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引用次数: 0

摘要

背景:深颈部感染(DNI)是一种潜在的危及生命的疾病,最常见的是由牙源性来源引起的。假牙经常充当多微生物生物膜的储藏库,促进口腔病原体的持续存在和潜在传播。尽管假牙被广泛使用,但假牙在个体患DNI的易感性中的作用尚未得到彻底的调查。本研究旨在阐明义齿使用与DNI发病率之间的可能联系,从而解决目前对DNI的东牙危险因素理解的空白。方法:回顾性纳入2018年8月至2024年7月期间诊断为DNI的337例患者。其中29人被确定为假牙佩戴者。系统分析相关临床参数,包括人口统计数据、合并症、感染特征和治疗结果,以评估与假牙使用的潜在关联。结果:假牙患者的DNI累及咽旁间隙(P = 0.0172)、下颌骨间隙(P = 0.0190)和腮腺间隙(P = 0.0213)的频率明显高于无假牙患者。单因素分析确定年龄≥60岁(优势比[OR] 27000;95%置信区间[CI], 2.5034-291.19;P = 0.0010), c反应蛋白(CRP)水平≥220 mg/L (OR 8.5000;95% ci, 1.2471-57.933;P = 0.0201),累及≥3个深颈间隙(OR 8.4444;95% ci, 1.2261-58.159;P = 0.0258)是延长住院时间的重要危险因素。然而,在多变量logistic回归分析中,只有年龄≥60岁仍然是延长住院时间的重要独立预测因子(OR 18.494;95% ci, 1.5789-216.63;p = .0201)。结论:在戴假牙的DNI患者中,单因素分析确定年龄为60岁或以上,CRP水平为220 mg/L或更高,以及涉及三个或更多深颈间隙是延长住院时间的重要预测因素。然而,多变量分析表明,只有60岁或以上的年龄仍然是延长住院时间的独立危险因素。这些发现强调需要对老年假牙使用者进行有针对性的健康教育和预防措施,以降低严重DNI及其并发症的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Multidisciplinary Analysis for Clinical Implications of Denture Use in Patients Presenting With Deep Neck Infections.

Background: Deep neck infection (DNI) is a potentially life-threatening condition, most commonly arising from odontogenic sources. Dentures frequently act as reservoirs for polymicrobial biofilms, facilitating the persistence and potential transmission of oral pathogens. Despite their widespread use, the role of dentures in predisposing individuals to DNI has not been thoroughly investigated. This study seeks to elucidate the possible association between denture use and the incidence of DNI, thereby addressing a gap in the current understanding of orodental risk factors in DNIs.

Methods: A total of 337 patients diagnosed with DNI between August 2018 and July 2024 were retrospectively enrolled in this study. Among them, 29 individuals were identified as denture wearers. Relevant clinical parameters, including demographic data, comorbidities, infection characteristics, and treatment outcomes, were systematically analyzed to assess potential associations with denture use.

Results: Involvement of the parapharyngeal (P = .0172), submandibular (P = .0190), and parotid (P = .0213) spaces in DNI was significantly more frequent in patients with dentures compared to those without. Univariate analysis identified age ≥60 years (odds ratio [OR] 27.000; 95% confidence interval [CI], 2.5034-291.19; P = .0010), C-reactive protein (CRP) level ≥220 mg/L (OR 8.5000; 95% CI, 1.2471-57.933; P = .0201), and involvement of ≥3 deep neck spaces (OR 8.4444; 95% CI, 1.2261-58.159; P = .0258) as significant risk factors for prolonged hospitalization. However, in multivariate logistic regression analysis, only age ≥60 years remained a significant independent predictor of prolonged hospitalization (OR 18.494; 95% CI, 1.5789-216.63; P = .0201).

Conclusion: In patients with DNI who wore dentures, univariate analysis identified age 60 years or older, CRP levels of 220 mg/L or higher, and involvement of three or more deep neck spaces as significant predictors of prolonged hospitalization. However, multivariate analysis demonstrated that only age 60 years or older remained an independent risk factor for extended hospital stay. These findings highlight the need for targeted health education and preventive measures in elderly denture users to reduce the risk of severe DNI and its complications.

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