Factors impacting hospitalization for periapical abscess
A recent study highlighted ongoing disparities in access to oral healthcare as evidenced by hospital-based factors among patients with periapical abscess — which is known to cause about 300 deaths in hospitals per year.
In The Journal of the American Dental Association, investigators used 2020 to 2022 data from the National Inpatient Sample database to explore potential strategies to improve outcomes in more than 145,000 patients hospitalized with a primary or secondary periapical abscess.
The investigators found that hospital costs (about $35,000 versus $86,500) and the length of stays (about three versus seven days) were lower among those who had primary periapical abscesses compared with those who had secondary abscesses. Certain factors such as age, race and ethnicity, income levels and region were correlated with the conditions; admission type, insurance status and comorbidities were also linked to the conditions. For instance, higher hospital costs were more prevalent among older patients, Black patients and Hispanic patients; those with nonelective admissions, those with no charge status and those receiving treatment in urban or Western U.S. hospitals also faced higher costs.
A large proportion of the participants also had comorbid hypertension or depression, demonstrating the possible influence of the bidirectional link between oral and psychological health. Patients with dementia or substance abuse more frequently experienced higher charges. Further, patients who identified as American Indian, those with the lowest quartile of income, and those with metastatic cancer, dementia, depression or substance abuse had a greater likelihood of experiencing longer hospital stays. In addition, those with secondary periapical abscesses were more likely to die compared with those who had primary abscesses; however, the investigators suggested this difference may have been because of the association between secondary abscesses and more severe infections.
The findings emphasized the need to identify approaches to improve access to preventive oral healthcare as well as hospital resource management.
Read more: JADA
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