Outcomes of Hospitalizations Attributed to Periapical Abscess from 2000-2008

Objectives: The current study examines longitudinal trends of hospitalizations primarily attributed to periapical abscess in the United States during a nine-year period (years 2000 to 2008).

Methods: The Nationwide Inpatient Sample (years 2000 to 2008), a component of the Healthcare Cost and Utilization Project sponsored by the Agency for Healthcare Research and Quality was used. All hospitalizations with a primary diagnosis for periapical abscess with/without sinus involvement were selected. The demographic characteristics and outcomes including hospital charges and length of stay were examined. All estimates are projected to nationally representative levels. Each individual hospitalization was the unit of analysis.

Results: During the nine-year study period (years 2000 to 2008), a total of 61,439 hospitalizations were primarily attributed to periapical abscess in the United States. Sinus involvement occurred in 3.2% of these hospitalizations. The average age was 37 years. 89% of all hospitalizations occurred on an emergency/urgent basis. Females comprised of 51% of all hospitalizations. The major payers were Medicare (18.7% of all hospitalizations), Medicaid (25.2%), private insurance plans (33.4%), and other insurance plans (4.2%). The uninsured comprised of 18.5% of all hospitalizations. 66 patients died in hospitals. The mean length of stay in hospital was 3 days and the total hospitalization days during the study period was 2,265,861 days. The mean hospitalization charge per visit ranged from $7,367 in year 2000 to $16,521 in year 2008. Northeast, Midwest, South, and Western regions accounted for 19.7%, 24.2%, 38.8%, and 17.3% of all hospitalizations respectively.

Conclusions: The current study highlights the hospitalization burden associated with periapical abscess, which is a condition that can be easily prevented with routine dental care. The high-risk groups that are likely to seek a hospital setting for periapical abscess were identified.