Mapping Hard Tissue Infections of Oral Cavity Leading to Sepsis of Oral Origin

Objectives: New consensus defines sepsis as a life-threatening organ dysfunction due to dysregulated host responses to infection that, in the oral cavity, may lead to severe organ damage, dysfunction, and death. The objective is expansion of a graph database schema involving sepsis and infection of the hard tissue of oral cavity needed to predict clinical patterns and outcomes for sepsis of oral origin.
Methods: A total of 22 papers including 8 case studies were obtained using PubMed and Google scholar. The process to map patterns and outcomes used Neo4j graph database principles. Data points were subjected to a meta-analysis (p=.05 significance level) when multiple data entries were reported. Averages or weighted average calculations were performed (Shapiro-Wilks, p=.05) when data did not meet the requirements for meta-analysis.
Results: The map begins with a patient record or conceptual patient node due to compilation of data points rather than a single data points as would occur in an actual patient traversing the graph database. The primary node traverses to other related nodes. Primary node to node relationships then traverse to the subject of interest, in this case, Infection, Sepsis, No Sepsis, and their sub-nodes: Origin, Non-oral and Oral involvement, along with their children nodes. The probability of an infection of oral origin becoming septic (SIRS diagnosis know or unknown) was 36.6%, not septic was 63.4%. The probability of sepsis from hard tissue infection is 33.5%, infections such as osteomyelitis, endodontic treatment, and restorative treatment may lead to sepsis. The children nodes traverse to pattern outcome termini.
Conclusions: A graph database schema has utility in mapping clinical patterns and outcomes of sepsis of oral origin, in this case, related to infections of the hard tissue of the oral cavity. This mapping indicates sepsis of the hard tissue of the oral cavity occurs at a rate of 33.%%