PathologyAre Emergency Medicine Physicians Able to Determine the Need for Computed Tomography and Specialist Consultation in Odontogenic Maxillofacial Infections?
Section snippets
Materials and Methods
After obtaining institutional review board approval (number 8991), the authors conducted a chart review. Patients were found through the billing department using International Classification of Diseases, Ninth Revision (ICD-9) codes at the University Medical Center in New Orleans, Louisiana, a large urban teaching hospital, from August 1, 2012 t April 30, 2015. The ICD-9 codes used were 528.3, 528.9, 682.0, and 682.1. Based on experience using these diagnosis codes, 1 in 5 to 1 in 10 charts
Results
There were 1,043 patients found in the initial search and 350 were randomly selected for review according to a computer-generated code. Of these 350 patients, 72 patients met the inclusion criteria and were included in the analysis. Patients were excluded for nonodontogenic etiology (73.4%), incomplete records (13.7%), recent trauma to the area of chief complaint (9.3%), recent surgery in the area of chief complaint (3.2%), and age younger than 18 years (0.4%). Table 1 presents demographics and
Discussion
The purpose of this study was to determine whether EM physicians can accurately determine the need for CT and specialist consultation in the management of odontogenic infections causing facial swelling. The hypothesis was that the discrepancy between triage management of odontogenic infections by EM physicians and the necessary workup determined by the specialist provider would be clinically relevant. The specific aim of the study was to assess CT use and specialist consultation by EM
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Cited by (5)
Update on Antimicrobial Therapy in Management of Acute Odontogenic Infection in Oral and Maxillofacial Surgery
2022, Oral and Maxillofacial Surgery Clinics of North AmericaCitation Excerpt :Christensen and colleagues20 performed a study that determined emergency medicine physicians conducted CT imaging on 61.7% of patients who did not require CT imaging by study standards. Recommendations were made to increase education to providers to avoid unnecessary imaging.20 There is a wide array of clinical imaging that can be used to assess head and neck infections in the emergency setting, but the most common is CT imaging with IV contrast in a hospital setting and cone beam CT or panoramic film if the patient is being evaluated in an outpatient clinic.
When to Order Computed Tomography for Odontogenic Infections
2019, Journal of Oral and Maxillofacial SurgeryEvidence-Based Clinical Criteria for Computed Tomography Imaging in Odontogenic Infections
2019, Journal of Oral and Maxillofacial SurgeryCitation Excerpt :This study is the first to examine the relation of clinical predictor variables to a diagnostic outcome variable in a prospective fashion in an attempt to define clinical guidelines for odontogenic infections. The need for these clinical criteria was made clear by a recent retrospective study that noted that EM physicians could not accurately judge the need for CT imaging and specialist consultation.6 However, it is far from the first to use CART analyses to define clinical guidelines.
Correlation between p16 and Interleukin-2 Gene Expression and Oral and Maxillofacial Wound Healing
2021, Indian Journal of Pharmaceutical SciencesPrevalence of odontogenic pain in a public dental urgency service in Southern Brazil
2020, Dental Press Endodontics
Conflict of Interest Disclosures: None of the authors have any relevant financial relationship(s) with a commercial interest.