The Role of C-Reactive Protein and Neutrophil to Lymphocyte Ratio in Predicting the Severity of Odontogenic Infections in Adult Patients

被引:9
|
作者
Rosca, Ovidiu [1 ]
Bumbu, Bogdan Andrei [2 ]
Ancusa, Oana [3 ]
Talpos, Serban [4 ]
Urechescu, Horatiu [4 ]
Ursoniu, Sorin [5 ]
Bloanca, Vlad [6 ]
Pricop, Marius [4 ]
机构
[1] Victor Babes Univ Med & Pharm Timisoara, Dept 13, Discipline Infect Dis, Eftimie Murgu Sq 2, Timisoara 300041, Romania
[2] Univ Oradea, Fac Med, Dept Dent Med, Univ St 1, Oradea 410087, Romania
[3] Victor Babes Univ Med & Pharm Timisoara, Fac Gen Med, Dept 5, Discipline Med Semiol, Eftimie Murgu Sq 2, Timisoara 300041, Romania
[4] Victor Babes Univ Med & Pharm Timisoara, Fac Dent Med, Discipline Oral & Maxillofacial Surg, Eftimie Murgu Sq 2, Timisoara 300041, Romania
[5] Victor Babes Univ Med, Ctr Translat Res & Syst Med, Dept Funct Sci, Eftimie Murgu Sq 2, Timisoara 300041, Romania
[6] Victor Babes Univ Med Pharm Timisoara, Dept Plast Surg, Eftimie Murgu Sq 2, Timisoara 300041, Romania
来源
MEDICINA-LITHUANIA | 2023年 / 59卷 / 01期
关键词
inflammatory markers; disease severity score; odontogenic infections; SPACE INFECTIONS; ADMISSION; CRITERIA; MARKER; IMPACT; COUNT;
D O I
10.3390/medicina59010020
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background and Objectives: Odontogenic infections (OI) represent a frequent cause of dental and maxillo-facial interventions, mostly due to late presentations or misdiagnosed complications. It is believed that the intensity of the immunoinflammatory response in OI is the main prognostic factor. Therefore, in this research, it was pursued to determine if the combination of C-reactive protein (CRP) and Neutrophil to Lymphocyte Ratio (NLR) (CRP-NLR) may serve as potential severity predictors in patients with odontogenic infections. Materials and Methods: A retrospective analysis on 108 patients hospitalized for odontogenic infections was conducted at the Department of Maxillofacial Surgery. Depending on the symptom severity scale, patients hospitalized with OI were divided into two equal groups based on infection severity (SS). Results: Patients with severe OI from Group B were associated more frequently with diabetes mellitus and smoking more often than those with a lower severity from Group A. In Group A, abscesses of odontogenic origin accounted for 70.4% of hospitalizations, while in Group B, abscesses and cellulitis were associated in 55.6% of cases (p-value < 0.001). The disease outcomes were more severe in Group B patients, where 22.2% of them developed sepsis, compared to 7.4% of Group A patients (p-value = 0.030). However, there was no significant difference in mortality rates. The SS and systemic immune inflammation index (SII) scores of Group B patients were substantially higher than Group A patients (13.6 vs. 6.1 for the SS score, p-value < 0.001), respectively, 2312.4 vs. 696.3 for the SII score (p-value < 0.001). All biomarker scores, including the CRP-NLR relationship, were considerably higher in Group B patients, with a median score of 341.4 vs. 79.0 in Group B (p-value < 0.001). The CRP-NLR association determined a 7.28-fold increased risk of severe OI. The receiver operating curve (ROC) analysis of CRP-NLR yielded an area under curve (AUC) value of 0.889, with high sensitivity (79.6%) and high specificity (85.1%), for predicting a severe odontogenic infection using biomarkers measured at hospital admission (p-value < 0.001). Conclusions: Therefore, it can be concluded that CRP-NLR is a reliable and affordable biomarker for determining the severity of odontogenic infections that may be included in other prognostic models for dental infections.
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页数:12
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