Admittance to the intensive care unit due to acute odontogenic cervicofacial infections; a single centre retrospective cohort study

Background: The aim of this study is to assess the outcome of the patients who required intensive care unit (ICU) admittance after surgical drainage of an odontogenic cervicofacial infection and identify the variables that are able to predict severe infection or a high possibility of complications.

Patients and methods: This is a retrospective cohort study including all adult patients admitted to our hospital over the period 2011-2020 due to odontogenic cervicofacial infection and required ICU admittance. The study was approved by the hospital's scientific committee (no 814-9/8/2021).

Results: 51 patients were included (mean age 43.2 years). 11.7% of the patients had major comorbidities, such as diabetes or immunosuppression. At presentation, fever was recorded in 55% patients and trismus in 92.8%, with a mean delay from symptoms to hospital admission at 3 days. 23% of patients had a post-extraction infection, 61% pericoronitis and 15% other odontogenic infections. The mean duration of hospitalization was 9.16 days whereas the mean ICU length of stay was 3.76 days. 84.3% of patients showed improvement, 13.7% deteriorated with a need of reoperation and one death was reported. ICU length of stay was associated with an 89% reduced rate when positive microbe identification was feasible, whereas rate of complications was 4-fold higher in patients with prolonged ICU length of stay.

Conclusions: Patients with deep cervicofacial odontogenic infections who require ICU management have a favourable clinical outcome. A minority of these patients will not improve in a short time frame or develop complications which require further management.