Outcomes of Hospitalizations Attributed to Periapical Abscess from 2000 to 2008: A Longitudinal Trend Analysis

doi:10.1016/j.joen.2013.04.042

Journal of Endodontics

Volume 39, Issue 9, September 2013, Pages 1104-1110

https://doi.org/10.1016/j.joen.2013.04.042 Get rights and content

Abstract

Introduction

Root canal therapy is a highly successful in-office treatment and preventive measure against periapical abscesses. Left untreated, periapical abscesses can have serious consequences that can lead to hospitalization. This study observes the trends of hospitalizations attributed to periapical abscesses.

Methods

A retrospective analysis of the Nationwide Inpatient Sample (years 2000–2008) was used; we selected cases with a primary diagnosis of a periapical abscess with/without sinus involvement. The demographic characteristics and outcomes were examined. Each individual hospitalization was the unit of analysis.

Results

During the 9-year study period, a total of 61,439 hospitalizations were primarily attributed to periapical abscesses in the United States. The average age was 37 years, and 89% of all hospitalizations occurred on an emergency/urgent basis. The mean length of stay was 2.96 days, and a total of 66 patients died in hospitals. Medicare, Medicaid, and private insurance plans paid for 18.7%, 25.2%, and 33.4% of hospitalizations, respectively. Uninsured patients accounted for 18.5% of hospitalizations. Significant predictors that influenced both hospital charges and length of stay included age, race, insurance status, a periapical abscess with sinus involvement, geographic region of country, the Charlson comorbidity index, and the year of study (P < .05).

Conclusions

The current study highlights the increasing burden of hospitalization of patients with periapical abscesses over a 9-year study period from 2000 to 2008. The high-risk groups likely to seek a hospital setting for the treatment of periapical abscesses were identified as were groups associated with higher hospital charges and a longer length of stay.

Section snippets

Dataset

The Nationwide Inpatient Sample (NIS) for the years 2000 to 2008 was used for the current study (9). The NIS dataset is 1 of the family of hospital-based datasets of the Healthcare Cost and Utilization Project sponsored by the Agency for Healthcare Research and Quality. The NIS dataset is a nationally representative inpatient hospitalization dataset in the United States that is designed to project close to 100% estimates of hospitalizations occurring annually. This is the largest publically

Overall Characteristics of Hospitalizations

During the 9-year study period (years 2000–2008), a total of 61,439 hospitalizations were primarily attributed to periapical abscesses in the United States. The descriptive characteristics and outcomes of those hospitalized for periapical abscesses are summarized in Tables 1 and 2. Sinus involvement occurred in 3.2% of these hospitalizations. The average age was 37 years, and women comprised 51.1% of all hospitalizations. Overall, 61.3% of the total hospitalizations occurred in white patients,

Discussion

To date, our study is the first to use a national data sample to examine hospitalization outcomes and document resource utilization trends involved in treating patients with periapical abscesses over the years 2000 to 2008.

Conclusions

A periapical abscess is a condition that can easily be identified and treated with routine dental care. The results of our study highlight the burden of hospitalizing patients with periapical abscesses over a 9-year study period from 2000 to 2008. During this time, there has been a 41.4% increase in the total number of discharges for periapical abscesses and a 32.3% rise in the number of emergency/urgent care admissions for periapical abscesses. Medicare and Medicaid were the primary payers for

Acknowledgments

The authors deny any conflicts of interest related to this study.

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Citation Excerpt :
Our cross-sectional study investigated the independent association between T2DM and AP in a large hospital population. From 2010 through 2020, the study of apical abscess in emergency hospital populations has received much attention and provided important public health information.14-16 However, these data did not provide information about other forms of AP or controlled associations with other health parameters and significant comorbidities.
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: Supported in part by a grant from the American Association of Endodontics Foundation.

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Clinical ResearchOutcomes of Hospitalizations Attributed to Periapical Abscess from 2000 to 2008: A Longitudinal Trend Analysis

Abstract

Introduction

Methods

Results

Conclusions

Section snippets

Dataset

Overall Characteristics of Hospitalizations

Discussion

Conclusions

Acknowledgments

Am J Emerg Med

Atlas Oral Maxillofac Surg Clin North Am

Emerg Med Clin North Am

J Infect

J Am Dent Assoc

J Chronic Dis

J Pediatr Health Care

Br J Oral Maxillofac Surg

Toothaches and death

J Hist Dent

Microbiology and treatment of dental abscesses and periodontal-endodontic lesions

Periodontol 2000

Hospital emergency department visits attributed to pulpal and periapical diseases in the United States in 2006

J Endod

Clinical Research
Outcomes of Hospitalizations Attributed to Periapical Abscess from 2000 to 2008: A Longitudinal Trend Analysis