Longitudinal Trends in Hospital-Based Emergency Department Visits Involving Periapical Abscesses

Objectives: Untreated periapical abscesses may advance to lesions that are severe enough to require hospital emergency visits. The objective of this study is to examine longitudinal trends in hospital based emergency department visits (ED) due to periapical abscess.
Methods: The Nationwide Emergency Department Sample for the years 2008 to 2013 was used. All ED visits with a diagnosis of periapical abscess were selected. Panel data analysis was conducted to examine longitudinal changes and trends associated with outcomes.
Results: During the study period, 2,959,940 ED visits contained a periapical abscess diagnosis which is about 0.4% of all United States emergency department visits. The number of ED visits per year increased from 460,260 in year 2008 to 525,856 in year 2013. Patients who were uninsured made up about 40.7% of ED visits. A vast majority of patients resided in low income areas. Within the study period, 54 patients died in hospital EDs. The average hospital emergency department charge per visit was approximately $1,060 and increased throughout the study period. The total emergency department charges across the United States during the 6 year study period was $2.8 billion. Close to 5% were hospitalized following the ED visit. The mean hospitalization charge for this cohort was close to $34,000 and the mean length of stay was 4 days. The total hospitalization charges across the entire United States was $4.6 Billion.
Conclusions: ED visits due to periapical abscess seem to be increasing during the 6 year study period thus causing a strain on the healthcare system. An extensive amount of hospital resources are used to treat periapical abscesses through the emergency department and patients are likely to acquire high charges.