TY - JOUR
T1 - The Cost of Surgically Treated Severe Odontogenic Infections
T2 - A Retrospective Study Using Severity Scores
AU - Neal, Timothy W.
AU - Hammad, Yousef
AU - Carr, Brian R.
AU - Schlieve, Thomas
N1 - Publisher Copyright:
© 2022 American Association of Oral and Maxillofacial Surgeons
PY - 2022/5
Y1 - 2022/5
N2 - Purpose: Hospital treatment of odontogenic infections can be costly, and often these infections present with varying degrees of severity that can be quantified with odontogenic infection severity scores (OISSs). The purposes of this study were (1) to measure the association between OISSs and hospital bills and (2) to identify risk factors associated with OISSs. Methods: This retrospective cohort study assessed subjects from January 1, 2016, to December 31, 2020, with severe odontogenic infections treated in the operating room and admitted to the University of Texas Southwestern Medical Center/Parkland Memorial Hospital for >1 hospital day. OISSs were assigned based on the risk to the airway and vital structures. OISSs ≥ 5 were designated group A and < OISSs 5 group B. The primary predictor variable was OISSs, and the primary outcome variable was the mean billed cost of the stay. Analysis to identify associated variables for OISS ≥ 5 was also conducted. Secondary predictor variables were age, gender, smoking status, HIV diagnosis, diabetes mellitus diagnosis, blood glucose at admission, and white blood cell count (WBC) at admission. The secondary outcome variable was OISS. Comparisons between Group A and Group B were conducted using t-tests. Analysis to identify associated variables for OISS ≥ 5 was conducted using univariate and multivariate analysis. Values of P <.05 were considered statistically significant. Results: There were 144 subjects that met inclusion criteria. There were 65 subjects in Group A and 69 in Group B. Group A had a significantly larger mean billed cost of stay (95% CI 8937.7 to 48,225.74; P =.001). Analysis of secondary predictor variables revealed that male sex (OR 2.07; 95% CI 1.06 to 4.07; P =.03), blood glucose ≥ 100 at presentation (OR 3.05; 95% CI 1.46 to 6.38; P =.002), and WBC of > 11,000/mL at presentation (OR 3.17; 95% CI 1.44 to 6.98; P =.003) resulted in an increased likelihood of OISS ≥ 5. Conclusions: Patients with OISSs ≥ 5 have higher mean billed costs when compared to patients with OISSs < 5. Male sex, blood glucose ≥ 100, and WBC >11,000/mL at presentation is associated with increased likelihood of OISS >5.
AB - Purpose: Hospital treatment of odontogenic infections can be costly, and often these infections present with varying degrees of severity that can be quantified with odontogenic infection severity scores (OISSs). The purposes of this study were (1) to measure the association between OISSs and hospital bills and (2) to identify risk factors associated with OISSs. Methods: This retrospective cohort study assessed subjects from January 1, 2016, to December 31, 2020, with severe odontogenic infections treated in the operating room and admitted to the University of Texas Southwestern Medical Center/Parkland Memorial Hospital for >1 hospital day. OISSs were assigned based on the risk to the airway and vital structures. OISSs ≥ 5 were designated group A and < OISSs 5 group B. The primary predictor variable was OISSs, and the primary outcome variable was the mean billed cost of the stay. Analysis to identify associated variables for OISS ≥ 5 was also conducted. Secondary predictor variables were age, gender, smoking status, HIV diagnosis, diabetes mellitus diagnosis, blood glucose at admission, and white blood cell count (WBC) at admission. The secondary outcome variable was OISS. Comparisons between Group A and Group B were conducted using t-tests. Analysis to identify associated variables for OISS ≥ 5 was conducted using univariate and multivariate analysis. Values of P <.05 were considered statistically significant. Results: There were 144 subjects that met inclusion criteria. There were 65 subjects in Group A and 69 in Group B. Group A had a significantly larger mean billed cost of stay (95% CI 8937.7 to 48,225.74; P =.001). Analysis of secondary predictor variables revealed that male sex (OR 2.07; 95% CI 1.06 to 4.07; P =.03), blood glucose ≥ 100 at presentation (OR 3.05; 95% CI 1.46 to 6.38; P =.002), and WBC of > 11,000/mL at presentation (OR 3.17; 95% CI 1.44 to 6.98; P =.003) resulted in an increased likelihood of OISS ≥ 5. Conclusions: Patients with OISSs ≥ 5 have higher mean billed costs when compared to patients with OISSs < 5. Male sex, blood glucose ≥ 100, and WBC >11,000/mL at presentation is associated with increased likelihood of OISS >5.
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U2 - 10.1016/j.joms.2022.01.001
DO - 10.1016/j.joms.2022.01.001
M3 - Article
C2 - 35120882
AN - SCOPUS:85124836663
SN - 0278-2391
VL - 80
SP - 897
EP - 901
JO - Journal of Oral and Maxillofacial Surgery
JF - Journal of Oral and Maxillofacial Surgery
IS - 5
ER -