Determinants of extended inpatient care in odontogenic cervicofacial infections: a retrospective observational study

BACKGROUND: This study aimed to identify clinical and demographic factors associated with prolonged hospitalisation in patients treated for severe odontogenic cervicofacial infections (CFI). METHODS: This retrospective study analysed 152 patients who were treated in an inpatient setting for CFI at the Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, between January 2022 and December 2023. Patients were stratified based on length of hospital stay (LOS) into two groups: <7 days and ≥ 7 days. Demographic, clinical, laboratory, treatment-related and timing data were compared to determine their association with prolonged LOS. RESULTS: Patients with prolonged hospitalisation (≥ 7 days; n = 79) were older and more frequently had recorded pre-existing disease, multi-space infection, submandibular or floor-of-mouth involvement, dyspnoea, elevated inflammatory markers and delayed presentation in unadjusted analyses. In multivariable logistic regression, recorded pre-existing disease (aOR 6.04, 95% CI 1.10-33.18; p = 0.038) and longer time from symptom onset to hospital presentation (aOR 2.86 per day, 95% CI 2.01-4.07; p < 0.001) remained independently associated with prolonged hospitalisation. CONCLUSIONS: Although several demographic, anatomical and clinical factors were associated with prolonged hospitalisation in unadjusted analyses, recorded pre-existing disease and delayed hospital presentation remained independently associated with prolonged LOS after multivariable adjustment. These findings highlight the potential importance of comorbidity and timely presentation in identifying patients at risk of extended inpatient care, but prospective multicentre validation is warranted.