Is patient-reported symptom onset associated with odontogenic infection severity?

Introduction: The purpose of this study was to determine if there is a relation between odontogenic infection severity score (OISS) and the time interval from patient-reported symptom onset to emergency department (ED) presentation. The working hypothesis was that higher OISSs would be found in patients who developed symptoms and delayed ED presentation compared with patients who presented earlier. Materials and Methods: The study population was composed of consecutive patients who were admitted to the University of Texas Southwestern Medical Center and surgically treated in the operating room for severe odontogenic infections from January 2016 to December 2020. Odontogenic infection severity was measured using a numerical severity index. Three cohort groups were predefined to evaluate the relation between patient-reported symptom onset in days and OISS. Results: There were 115 patients who met the inclusion and exclusion criteria. There was no significant difference in the OISSs between the three cohorts. In patients who received antibiotics prior to ED presentation, there was no difference in OISS. Male sex and diabetes diagnosis were related to higher OISSs. Conclusions: Patient-reported symptom onset is unrelated to OISS in patients treated surgically for severe odontogenic infections. Other patient-specific factors such as diabetes diagnosis are related to higher OISSs.