The use of steroids in cervicofacial infections in UK OMFS departments: a Maxillofacial Surgery Trainees Research Collaborative (MTReC) study

• Published in: Oral and maxillofacial surgery Vol. 25; no. 3; pp. 345 - 349
• Main Author: Kent, Samuel
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2021; Springer Nature B.V
• Subjects: Abscesses; Audits; Cardiovascular disease; Collaboration; Dentistry; Diabetes; Dysphagia; Heart rate; Hospitals; Infections; Ischemia; Length of stay; Maxillofacial surgery; Medicine; Medicine & Public Health; Oral and Maxillofacial Surgery; Original Article; Pain; Patients; Physiology; Steroids; United Kingdom > UK; Cervicofacial infection; Diabetes mellitus; Steroids; Length of stay
• ISSN: 1865-1550; 1865-1569
• DOI: 10.1007/s10006-020-00922-y

Introduction Defining current inpatient management of cervicofacial infections is key to identifying strategies to optimise care. Steroid use is beneficial in peritonsillar and orbital abscess, but there are few studies of steroid use in odontogenic cervicofacial infections. Our previous research identified widespread variation in practice, necessitating a national audit to define current practice. Methods A multicentre, trainee-led snapshot audit was carried out across 25 hospitals in the UK. Information recorded included demographic features, presentation, surgical and medical management, and steroid administration. Results One thousand two admissions were recorded. Fifty-five percent were male, with mean age 37.3 years (range 0–94 years). Steroids were administered to 357 patients (36%), 159 of whom received steroids on admission, and 254 peri-operatively. Patients who were prescribed steroids had significantly higher white cell count (12.4 vs 11.5), CRP (79.5 vs 57) and heart rate (94 vs 88) on admission. Justifications given for administration included swelling (74), dysphagia (21), and airway compromise (7). Three patients (0.8%) reported steroid-related side effects. Conclusions This study uses the largest recorded cohort of cervicofacial infections to define current inpatient steroid administration. Our results suggest that steroids are targeted towards the most compromised 1/3 of patients. The incidence of steroid-related side effects was low. Defining the characteristics of patients currently receiving steroids will aid in determining whether steroid administration is an effective adjunct in treating odontogenic cervicofacial infection.