Analysis of orofacial infections in Johannesburg, South Africa

ABSTRACT Introduction: Orofacial infections remain a significant cause of morbidity, particularly in low- and middle-income countries. Limited data exist on factors influencing treatment outcomes and hospital stay in South Africa. This study aimed to assess the clinical presentation, management, outcomes, and predictors of hospital stay duration. Patients and Methods: All patients aged 18 years or older diagnosed with orofacial infections at two academic hospitals over 1 year (2022) were included in the study. All patients had antibiotic therapy, and all but four had maxillofacial surgery involving tooth extraction, drainage of abscesses, and/or repair of fractures. The collected data included demographics, clinical presentation, infection microbiology, special investigations, comorbidities, and the extent of disease spread. Statistical analyses were performed to identify factors with a significant impact on the length of stay and patient outcomes. Results: A total of 152 patients were included in the study. Dental caries was the most common cause, with trismus as the most common symptom. The majority had multi-space involvement, and 17 cases of Ludwig's Angina were recorded. Patients with diabetes had significantly longer hospital stays (t = -1.806; df = 150; p = 0.036). The median length of stay was five days. Infections originating from mandibular 3rd molars, multi-space involvement, and dysphagia were associated with prolonged hospital stay. Conclusion: The study identifies key predictors of prolonged hospital stay, emphasising the importance of early risk stratification. Knowledge of these predictive factors not only enhances the ability to predict hospitalisation length but also lays the foundation for mobilising resources and integrating them into primary prevention programs.