Abstract

Prognostic Value of Transthyretin Levels in Maxillofacial Infection

Author(s):Ashish J Rai, Padmaraj Hegde, Tripthi P Shetty, Chrysl K Castelino and Ashmitha K Shetty

Introduction: The Nutritional status in hospitalized maxillofacial infection patients is of great importance. These patients may develop rapidly various deficiencies and wasting. Unfortunately, most of these deficiencies go unrecognized. Considerable efforts have therefore been made to identify patients at risk of malnutrition, with a view to the early provision of nutritional support. Determining the level of Transthyretin, a hepatic protein, is the earliest laboratory indicator of nutritional status and has emerged as the preferred marker for malnutrition. Objectives: The objective of the study is to assess the transthyretin level in the patient with infections in the maxillofacial region and correlate between transthyretin concentration and length of hospital stay. Study design: A prospective study done on 80 patients who were admitted for maxillofacial infections between 2011 and 2013. We recorded the number of infected spaces and transthyretin. Correlations between the duration of hospital stay, number of facial spaces involved and the variation in transthyretin concentration during the time of admission and discharge were assessed. Results: A total of 80 patients (44 males and 36 females) based on the transthyretin level during admission were grouped into high risk (5%), moderate risk (37.5%) and no risk (57.5%). As the severity increased the transthyretin levels decreased. The severity of the infection which was determined by the transthyretin levels has statistical significance with hospital stay during admission and discharge which shows that 78% of the patients were in no risk category who were admitted for 1 to 3 days and the patients who were admitted for more than 3 days have shown 63.3% in moderate risk and 13.3% in high-risk category. The study also shows how the variation seen in transthyretin levels during the time of admission and discharge has shown a significant correlation with hospital stay (0.549) and the no. of spaces (0.442).  Conclusion: Transthyretin can be used as a diagnostic tool in assessing the nutritional status in patients with a maxillofacial infection which helps in improving the prognosis and reduce the duration of hospital stay. 

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