Outcomes in patients hospitalized for periapical abscess in the United States: an analysis involving the use of a nationwide inpatient sample.
ABSTRACT Severe infections resulting from periapical abscesses may warrant hospitalization. The authors conducted a study to investigate the factors affecting outcomes for patients hospitalized for periapical abscess in the United States in 2007.
The authors used the Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project for 2007. They selected for analysis all hospitalizations attributed primarily to periapical abscess. Outcomes examined included hospitalization charges, length of stay and type of admission (emergency or urgent versus elective). They used multivariable regression analysis to examine the effects of patient-related factors (including age, sex, presence of comorbid conditions, insurance status, type of periapical abscess and discharge disposition) on outcomes.
In 2007, 7,886 hospitalizations were attributed primarily to periapical abscess. Total hospital charges were $105.8 million. Periapical abscess also resulted in a total of 23,001 hospitalization days. The mean hospitalization charges and length of stay were $13,590 and 2.92 days, respectively. The authors found an association between patients with comorbid conditions and higher charges and longer length of stay (P < .05). Of all hospitalizations, 91 percent occurred on an emergency or urgent basis. The percentage was significantly higher among uninsured patients than among those with private insurance (P < .05).
The study provides nationally representative estimates of outcomes associated with hospitalizations due to periapical abscess, and it highlights the substantial resources needed to treat patients hospitalized for this condition.
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ABSTRACT: Investigators have examined children's dental utilization in various settings (e.g., dental offices, emergency departments, operating rooms), but no studies have examined inpatient hospitalizations for non-traumatic dental conditions (NTDCs). The authors examined NTDC-related hospitalization trends in the United States and identified the relationship between complex chronic condition (CCCs) and NTDC-related inpatient hospitalizations. We analyzed data from the U.S. Nationwide Inpatient Sample (2000-2010) for children ages 3 to 17 years (N = 3,030,970). The predictor variable was number of CCCs (0/1/2+). The outcome variable was whether the child had a NTDC-related hospitalization (no/yes). Covariate-adjusted multivariable logistic regression models were used to estimate prevalence odds ratios (PORs). From 2000 to 2010, there were 17,993 NTDC-related hospitalizations (0.59%) and a slight increase in NTDC-related hospitalizations (p = .049). This increase was not significant in the final regression model. There was no difference in odds of NTDCs for children with 0 or 1 CCCs (POR = 1.08; 95%CI = 0.99, 1.18), but children with 2+ CCCs had significantly greater odds (POR = 1.61; 95%CI = 1.42, 1.83), as did non-White, publicly insured, and lower income children. NTDC-related hospitalizations for children did not increase from 2000 to 2010. Children with 2+ CCCs had the greatest odds of being hospitalized for NTDCs, which highlights the need to develop preventive interventions targeting children with 2+ CCCs.Journal of dental research 05/2013; 92(8). DOI:10.1177/0022034513490733 · 4.14 Impact Factor
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ABSTRACT: SUMMARY Acute apical abscess is the most common form of dental abscess and is caused by infection of the root canal of the tooth. It is usually localized intraorally, but in some cases the apical abscess may spread and result in severe complications or even mortality. The reasons why dental root canal infections can become symptomatic and evolve to severe spreading and sometimes life-threatening abscesses remain elusive. Studies using culture and advanced molecular microbiology methods for microbial identification in apical abscesses have demonstrated a multispecies community conspicuously dominated by anaerobic bacteria. Species/phylotypes commonly found in these infections belong to the genera Fusobacterium, Parvimonas, Prevotella, Porphyromonas, Dialister, Streptococcus, and Treponema. Advances in DNA sequencing technologies and computational biology have substantially enhanced the knowledge of the microbiota associated with acute apical abscesses and shed some light on the etiopathogeny of this disease. Species richness and abundance and the resulting network of interactions among community members may affect the collective pathogenicity and contribute to the development of acute infections. Disease modifiers, including transient or permanent host-related factors, may also influence the development and severity of acute abscesses. This review focuses on the current evidence about the etiology and treatment of acute apical abscesses and how the process is influenced by host-related factors and proposes future directions in research, diagnosis, and therapeutic approaches to deal with this disease.Clinical microbiology reviews 04/2013; 26(2):255-73. DOI:10.1128/CMR.00082-12 · 16.00 Impact Factor
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ABSTRACT: The objective of this study was to provide estimates of hospitalizations attributed to oral health related conditions in the United States (US). The nationwide inpatient sample (NIS) of the Healthcare Cost and Utilization Project (HCUP) for 2008 was used. Hospital admissions with a primary diagnosis of dental/oral health-related conditions were identified using ICD-9-CM diagnosis codes. A total of 50,658 hospital admissions were primarily attributed to oral health-related conditions in 2008. Total US hospitalization charges were $1.218 billion. Total US hospitalization days were 174,496 days. The current study examines outcomes in patients hospitalized primarily for dental/oral health-related conditions. Of 39,885,120 hospitalizations that occurred in the US, a total of 50,658 (1.27%) were primarily attributed to dental-related conditions. Substantial resources are spent in treating dental-related conditions in hospital settings.09/2012; 114(3):333-7. DOI:10.1016/j.oooo.2012.03.024