Epidemiological Characteristics and Risk Factors for Prolonged Hospitalisation in Oral and Maxillofacial Space Infections: A 3-Year Retrospective Study of 217 cases

Background Oral and maxillofacial space infections (OMSIs) are a serious emergency disease in oral and maxillofacial departments; untreated or undertreated OMSI can lead to serious complications and can be life-threatening. This study aimed to comprehensively analyse the epidemiological characteristics of OMSI, identify the associated etiological and risk factors, and develop a machine learning-based predictive model for factors influencing hospitalisation. Methods Medical records of 217 patients hospitalised with OMSI were retrospectively analysed. Demographic data, clinical characteristics, treatment histories, microbiological profiles, and drug sensitivity test results were reviewed. A risk prediction model for hospitalisation length was established using machine learning. Results Odontogenic infections (69.41%) were the most common etiological factors for OMSI, with periapical periodontitis being the most prevalent. Streptococcus spp. was the most frequently cultured aerobic bacteria, whereas Peptostreptococcus anaerobius was the predominant anaerobe. Drug sensitivity tests indicated high resistance rates to clindamycin and erythromycin among aerobic bacteria. The risk prediction model exhibited an area under the curve of 0.726 and was validated by an internal area under the curve of 0.712. Factors such as hypertension, diabetes, pre-admission interventions, and age were significantly associated with prolonged hospitalisation. Conclusion Periapical periodontitis remains a primary cause of OMSI; however, the rising incidence of infections due to cosmetic injections and implant surgeries warrants attention. Penicillin, clindamycin, and erythromycin are not recommended as empirical first-choice drugs. The predictive model effectively identified risk factors for extended hospitalisation. Hypertension, diabetes, pre-admission interventions, and age are risk factors for lengthened hospitalisation. Efforts should be made to promote oral hygiene education and healthcare system reforms in regions with similar demographic and socioeconomic conditions.