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Analysis of glycosylated hemoglobin (HbA1c) level on maxillofacial fascial space infection in diabetic patients

Journal of the Korean Association of Oral and Maxillofacial Surgeons / Journal of the Korean Association of Oral and Maxillofacial Surgeons, (P)2234-7550; (E)2234-5930
2015, v.41 no.5, pp.251-258



Abstract

Objectives: This study was performed to evaluate the impact of glycosylated hemoglobin (HbA1c) level on characteristics and prognosis of maxil-lofacial fascial infection in diabetic patients.Materials and Methods: We reviewed the medical records of 72 patients (35 patients with HbA1c lower than 7.0% and 37 patients with HbA1c higher than 7.0%) diagnosed with maxillofacial fascial space infection and hospitalized for treatment at the Department of Oral and Maxillofacial Sur-gery in Dankook University Hospital (Cheonan, Korea) from January 2005 to February 2014. We compared demographics, parameters of glucoregula-tion (HbA1c), laboratory parameters of inflammation(white blood cell [WBC], C-reactive protein [CRP] count), type and number of involved spaces, type and number of antibiotics, period of hospitalization, number of surgical operations, need for tracheostomy, complications, computed tomography (CT), and microorganisms between the two groups.Results: Compared with the well-controlled diabetes mellitus (DM) group (HbA1c <7.0%), patients in the poorly-controlled (HbA1c ≥7.0%) DM group had the following characteristics: longer hospitalization periods, higher values of laboratory parameters of inflammation(WBC, CRP count) at the time of admission, higher number of antibiotics prescribed, more frequent complications, frequent deep neck space involvement, and distinctive main causative microorganisms. As the HbA1c level increases, hospitalization periods and incidence of complications increase gradually.Conclusion: This retrospective study suggests that regulation of DM significantlyimpacts maxillofacial fascial infection. Poorly controlled DM with high HbA1c level negatively influences the prognosis of infectin.

keywords
Glycosylated hemoglobin A, Dental infection control, Diabetes mellitus

Journal of the Korean Association of Oral and Maxillofacial Surgeons