Predictors and Risk Factors for admission to Critical Care in Cervicofacial Infections ; A Maxillofacial Trainees Research Collaborative (MTReC) Study

Published:November 18, 2022DOI:



      Cervicofacial infections carry significant morbidity. Patients present on a broad spectrum of severity, with some requiring outpatient management, and others admission to higher level care. Recognition of risk factors is helpful in decision making regarding the need for admission to higher level care.


      Prospective data was captured for 1002 patients in 25 centres across 17 regions of the United Kingdom (UK) by the Maxillofacial Trainees Research Collaborative (MTReC). Patients admitted to critical care were compared with those receiving ward level care. Multivariate and receiver operating characteristic curve analyses was used to identify the predictors for critical care admission.


      Our results show three or more features of airway compromise was the best predictor for critical care admission (AUC 0.779) followed by C-reactive protein (CRP) > 100 mg/L (OR 2.70; CI 1.59 – 4.58 P <0.005), submandibular space involvement (OR 3.82; Confidence Interval (95% CI) 1.870 – 7.81 P=0.003), white cell count (WCC) > 12 x 109/ dl (1.05; (95% CI)1.01 - 1.10 p = 0.03), systemic inflammatory response syndrome criteria positive (OR 2.78; CI 1.35 – 5.80 P = 0.006).


      Admission to critical care is multi-factorial however three or more features of airway compromise was the best predictor. Awareness of this alongside other key clinical findings in cervicofacial infections may allow early recognition of patients who may require escalation to critical care.


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