To investigate the association between serum albumin (ALB) levels at admission and the disease severity and prognosis of patients with maxillofacial space infection (MSI), and to analyze the risk factors for prolonged length of hospital stay (LOS).

A retrospective analysis was conducted on the clinical data of 154 patients with MSI admitted to Qilu Hospital of Shandong University from January 1, 2022, to December 31, 2024. Based on the initial serum ALB level measured at admission, the patients were divided into three groups: <30 g/L, 30–35 g/L, and >35 g/L. The clinical characteristics were compared among the three ALB groups. Univariate analysis was performed to evaluate the association of clinical characteristics and ALB levels with prolonged length of hospital stay (LOS>14 days) and in-hospital mortality. Variables with P<0.05 in the univariate analysis, as well as variables considered clinically meaningful were subsequently included in multivariate logistic regression analysis to identify independent risk factors for prolonged LOS.

A total of 154 patients were included, of whom 141 (91.6%) survived and 13 (8.4%) died. 26 patients (16.9%) had a prolonged LOS (>14 days). Serum ALB levels were significantly associated with age, number of involved fascial spaces, neutrophil percentage, white blood cell count, and prealbumin level (all P<0.05). Lower ALB levels were associated with a higher incidence of prolonged LOS (χ²=14.033, P<0.001) and increased in-hospital mortality (χ²=11.565, P=0.003). Multivariate logistic regression analysis demonstrated that, after adjustment for age, number of involved fascial spaces, descending necrotizing mediastinitis (DNM), surgical treatment, and neutrophil percentage, patients with ALB levels of 30–35 g/L (OR=0.22, 95% CI: 0.07-0.73,  P=0.013) and >35 g/L (OR=0.13, 95% CI: 0.03-0.48,  P=0.002) had significantly lower risks of prolonged LOS compared with those with ALB levels <30 g/L, indicating that lower ALB level was an independent predictor of prolonged LOS.

Low serum ALB level at admission was significantly associated with prolonged LOS and increased risk of in-hospital mortality in patients with MSI, and was identified as an independent risk factor for prolonged LOS. Serum ALB may serve as a simple and practical biomarker for assessing disease severity and prognosis in MSI, facilitating early risk stratification and aiding in the formulation of individualized treatment strategies in clinical practice.

探讨患者入院时血清白蛋白（albumin，ALB）水平与颌面部间隙感染（maxillofacial space infection，MSI）病情严重程度及预后的关系，并分析患者住院时间（length of hospital stay，LOS）延长的危险因素。

回顾性分析2022年1月1日至2024年12月31日山东大学齐鲁医院收治的154例MSI患者的临床资料。根据入院时首次检测的ALB水平，将患者分为ALB<30 g/L组、30~35 g/L组和>35 g/L组。比较不同ALB水平患者的临床特征，并采用单因素分析法评价临床特征、ALB水平与LOS延长（LOS>14 d）及生存结局的关系；将单因素分析中P<0.05及具有临床意义的变量纳入多因素Logistic回归分析，筛选LOS延长的独立影响因素。

共纳入154例患者，其中存活141例（91.6%）、死亡13例（8.4%），26例（16.9%）患者LOS>14 d。ALB水平与年龄、感染间隙数、中性粒细胞比例、白细胞计数及前白蛋白水平有关（均P<0.05）。ALB水平越低，LOS延长发生率越高（χ²=14.033，P<0.001），院内死亡率亦越高（χ²=11.565，P=0.003）。多因素Logistic回归分析显示，在校正年龄、感染间隙数、下行性坏死性纵隔炎（descending necrotizing mediastinitis，DNM）、手术治疗及中性粒细胞比例等因素后，与ALB<30 g/L组相比，ALB 30~35 g/L组（OR=0.22，95%CI：0.07~0.73，P=0.013）和ALB>35 g/L组（OR=0.13，95%CI：0.03~0.48，P=0.002）发生LOS延长的风险均显著降低，提示低水平ALB是LOS延长的独立危险因素。

入院时低ALB水平与MSI患者LOS延长及院内死亡风险增加显著相关，是LOS延长的独立危险因素。ALB可作为评估MSI病情严重程度及预后的简便指标，有助于临床早期风险分层及制定个体化治疗策略。