Comparative Assessment of the qSOFA, SII, dNLR, and OISS Infection Severity Scores in Diabetic Versus Non-Diabetic Patients with Odontogenic Infections

Background and Objectives: Odontogenic infections (OIs) can progress rapidly and may lead to severe systemic complications, especially in patients with underlying conditions like diabetes mellitus (DM). This study aims to evaluate the predictive value of inflammatory scores-quick Sequential Organ Failure Assessment (qSOFA), Systemic Immune-Inflammation Index (SII), derived Neutrophil-to-Lymphocyte Ratio (dNLR), and Odontogenic Infection Severity Score (OISS)-in assessing the severity of OIs in diabetic versus non-diabetic patients. Materials and Methods: A case-control study was conducted on 123 patients diagnosed with OIs. Patients were divided into two groups: patients with diabetes (n = 42) and patients who were non-diabetic (n = 81). Inflammatory scores were calculated at admission and correlated with clinical outcomes. Statistical analyses included t-tests, chi-square tests, and multivariate logistic regression. Results: The patients with diabetes exhibited significantly higher OISS scores (mean 6.5 +/- 2.8) compared to the patients who were non-diabetic (mean 4.8 +/- 2.1, p < 0.001). The inflammatory markers qSOFA, SII, and dNLR were significantly elevated in the diabetic group (all p < 0.01). The SII demonstrated the highest predictive accuracy for severe OIs in patients with diabetes, with an area under the curve (AUC) of 0.88 (95% CI: 0.80-0.95). Diabetes mellitus was an independent predictor of severe OIs (OR: 3.2, 95% CI: 1.5-6.8, p = 0.003). Conclusions: Inflammatory scores, particularly SII, are effective in predicting the severity of odontogenic infections in patients with diabetes. Incorporating these scores into clinical practice may enhance the early identification of high-risk patients and improve management strategies.