Construction of a Risk Score Model for Predicting Airway Management in Maxillofacial and Neck Region Space Infections Using Inflammatory Markers

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Titel: Construction of a Risk Score Model for Predicting Airway Management in Maxillofacial and Neck Region Space Infections Using Inflammatory Markers
Autoren: Wang X, Shi H, Qian W, Zhou Q, Wang B, Zhang W, Li H, Zheng L
Quelle: Journal of Inflammation Research, Vol 18, Iss Issue 1, Pp 15379-15392 (2025)
Verlagsinformationen: Dove Medical Press, 2025.
Publikationsjahr: 2025
Bestand: LCC:Pathology
LCC:Therapeutics. Pharmacology
Schlagwörter: Oral and maxillofacial space infections, risk scoring system, predictive modeling, clinical decision-making, Pathology, RB1-214, Therapeutics. Pharmacology, RM1-950
Beschreibung: Xijun Wang,1– 5,* Huan Shi,1– 5,* Wentao Qian,1– 5 Qin Zhou,1– 5 Baoli Wang,1– 5 Wenhao Zhang,1– 5 Hui Li,1– 5 Lingyan Zheng1– 5 1Department of Oral Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People’s Republic of China; 2College of Stomatology, Shanghai Jiao Tong University, Shanghai, People’s Republic of China; 3National Center for Stomatology, Shanghai, People’s Republic of China; 4National Clinical Research Center for Oral Diseases, Shanghai, People’s Republic of China; 5Shanghai Key Laboratory of Stomatology, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Lingyan Zheng, Department of Oral Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 ZhiZaoJu Road, Shanghai, 200011, People’s Republic of China, Email zhenglingyan73@163.com Hui Li, Department of Oral Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 ZhiZaoJu Road, Shanghai, 200011, People’s Republic of China, Email lihui9x@163.comPurpose: Patients with oral and maxillofacial space infections (OMSI) often experience rapidly progressing disease that can result in acute hypoxia, leading to severe complications such as cerebral hypoxia and cardiac arrest. Effective airway management (intubation or tracheotomy) is crucial in these cases. However, no validated tools currently exist to predict which patients require airway intervention. This study aimed to develop and validate a risk scoring system to predict the need for airway management in patients with OMSI.Patients and Methods: We conducted a retrospective study of OMSI patients treated between January 2020 and December 2022 and divided them into training and validation cohorts. A risk prediction model was developed using LASSO and logistic regression analyses in the training cohort, and its discrimination and calibration were verified in the validation cohort.Results: A total of 215 patients (150 for training and 65 for validation) were analyzed. Six independent predictors were identified: dyspnea (OR 3.95, 95% CI 1.38– 11.35, p = 0.011), BMI (OR 1.14, 95% CI 1.04– 1.25, p = 0.006), body temperature (OR 2.92, 95% CI 1.34– 6.37, p = 0.007), sIL-2R level (OR 1.01, 95% CI 1.01– 1.01, p = 0.007), CRP level (OR 1.01, 95% CI 1.01– 1.01, p = 0.047), and retropharyngeal space involvement (OR 15.71, 95% CI 3.36– 73.40, p < 0.001). Internal validation revealed good discrimination (AUC 0.91) and calibration (HL test, p = 0.061), with similar performance in the validation cohort (AUC 0.86; HL test, p = 0.133). Decision curve analysis demonstrated clinical utility in both cohorts.Conclusion: The proposed risk scoring system reliably predicts the need for airway management in OMSI patients, which enables clinicians to identify high-risk patients early and implement preventive strategies to improve outcomes.Keywords: oral and maxillofacial space infections, risk scoring system, predictive modeling, clinical decision-making
Publikationsart: article
Dateibeschreibung: electronic resource
Sprache: English
ISSN: 1178-7031
Relation: https://www.dovepress.com/construction-of-a-risk-score-model-for-predicting-airway-management-in-peer-reviewed-fulltext-article-JIR; https://doaj.org/toc/1178-7031
Zugangs-URL: https://doaj.org/article/c655017e8d74427faff2b9e7c480b949
Dokumentencode: edsdoj.655017e8d74427faff2b9e7c480b949
Datenbank: Directory of Open Access Journals
Beschreibung
Abstract:Xijun Wang,1– 5,&ast; Huan Shi,1– 5,&ast; Wentao Qian,1– 5 Qin Zhou,1– 5 Baoli Wang,1– 5 Wenhao Zhang,1– 5 Hui Li,1– 5 Lingyan Zheng1– 5 1Department of Oral Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People’s Republic of China; 2College of Stomatology, Shanghai Jiao Tong University, Shanghai, People’s Republic of China; 3National Center for Stomatology, Shanghai, People’s Republic of China; 4National Clinical Research Center for Oral Diseases, Shanghai, People’s Republic of China; 5Shanghai Key Laboratory of Stomatology, Shanghai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Lingyan Zheng, Department of Oral Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 ZhiZaoJu Road, Shanghai, 200011, People’s Republic of China, Email zhenglingyan73@163.com Hui Li, Department of Oral Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 ZhiZaoJu Road, Shanghai, 200011, People’s Republic of China, Email lihui9x@163.comPurpose: Patients with oral and maxillofacial space infections (OMSI) often experience rapidly progressing disease that can result in acute hypoxia, leading to severe complications such as cerebral hypoxia and cardiac arrest. Effective airway management (intubation or tracheotomy) is crucial in these cases. However, no validated tools currently exist to predict which patients require airway intervention. This study aimed to develop and validate a risk scoring system to predict the need for airway management in patients with OMSI.Patients and Methods: We conducted a retrospective study of OMSI patients treated between January 2020 and December 2022 and divided them into training and validation cohorts. A risk prediction model was developed using LASSO and logistic regression analyses in the training cohort, and its discrimination and calibration were verified in the validation cohort.Results: A total of 215 patients (150 for training and 65 for validation) were analyzed. Six independent predictors were identified: dyspnea (OR 3.95, 95% CI 1.38– 11.35, p = 0.011), BMI (OR 1.14, 95% CI 1.04– 1.25, p = 0.006), body temperature (OR 2.92, 95% CI 1.34– 6.37, p = 0.007), sIL-2R level (OR 1.01, 95% CI 1.01– 1.01, p = 0.007), CRP level (OR 1.01, 95% CI 1.01– 1.01, p = 0.047), and retropharyngeal space involvement (OR 15.71, 95% CI 3.36– 73.40, p < 0.001). Internal validation revealed good discrimination (AUC 0.91) and calibration (HL test, p = 0.061), with similar performance in the validation cohort (AUC 0.86; HL test, p = 0.133). Decision curve analysis demonstrated clinical utility in both cohorts.Conclusion: The proposed risk scoring system reliably predicts the need for airway management in OMSI patients, which enables clinicians to identify high-risk patients early and implement preventive strategies to improve outcomes.Keywords: oral and maxillofacial space infections, risk scoring system, predictive modeling, clinical decision-making
ISSN:11787031