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Open Access Research article

Risk factors of recurrence and life-threatening complications for patients hospitalized with chronic suppurative osteomyelitis of the jaw

Lin Chen12, Tangxin Li3, Wei Jing2, Wei Tang1, Weidong Tian1, Cai Li2* and Lei Liu1*

Author Affiliations

1 Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, P.R. China

2 State Key Laboratory of Oral Diseases, Sichuan University, Chengdu 610044, P.R. China

3 Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou 510055, P.R.China

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BMC Infectious Diseases 2013, 13:313  doi:10.1186/1471-2334-13-313

Published: 11 July 2013

Abstract

Background

Clinically, recurrence and life-threatening complications are challenging problems for chronic suppurative osteomyelitis of the jaw (CSOJ), but there is no quantitative analysis or report about the causes of or risk factors for the two problems to date. Doctors identify the causes or risk factors only through clinical experience. We performed a retrospective study of 322 patients with CSOJ to quantificationally analysed the risk factors for the abovementioned two problems by logistic regression analysis.

Methods

A retrospective study of 322 patients hospitalized with CSOJ was performed. The socio-demographic and clinical characteristics were recorded. The risk factors for the above two problems were analyzed by logistic regression analysis. Frequency and percentage were used to indicate descriptive research factors. A univariate logistic regression analysis was performed to calculate the odds ratio (OR) and to identify independent risk factors. The independent risk factors were further identified by multivariate logistic regression analysis.

Results

An age from 6–12 years or > 65 years, pre-admission antibiotic administration, a lesion at the mandibular ramus, concurrent maxillofacial space infection (MSI), and conservation of pathogenic teeth were found to be risk factors for recurrence. An age > 65 years, admission temperature > 39 degree Celsius, admission white blood cell (WBC) count >15×109/L, pre-admission antibiotic administration, concurrent MSI, pre-existing diabetes, and respiratory difficulty were found to be risk factors for life-threatening complications.

Conclusions

The results indicate that doctors should remain mindful of the risk factors listed above, and the management of CSOJ should be increasingly aggressive when the above risk factors are present, especially when the lesion is located at the mandibular ramus. In addition, pathogenic teeth must be extracted, and antibiotics should be administered properly.

Trial registration

Clinicaltrials.gov (NCT01670422)

Keywords:
Chronic suppurative osteomyelitis of the jaw; Recurrence; Life-threatening complications; Risk factors; Logistic regression analysis