The pathological oral cavity as a preventable source of postoperative pneumonia in thoracic surgery: a prospective observational study.

Autor:	Ploenes T; Department of Thoracic Surgery and Thoracic Endoscopy, Ruhrlandklinik, West German Lung Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany., Pollok A; Department of Thoracic Surgery and Thoracic Endoscopy, Ruhrlandklinik, West German Lung Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany., Jöckel KH; Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Germany., Kampe S; Department of Anesthesiology, Ruhrlandklinik, West German Lung Center, University of Duisburg-Essen, Essen, Germany.; Department of Anesthesiology and Intensive Care Medicine, University Hospital Magdeburg, Otto von Guericke University Magdeburg, Magdeburg, Germany., Darwiche K; Department of Pneumology, Ruhrlandklinik, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany., Taube C; Department of Pneumology, Ruhrlandklinik, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany., Buer J; Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany., Aigner C; Department of Thoracic Surgery and Thoracic Endoscopy, Ruhrlandklinik, West German Lung Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
Jazyk:	angličtina
Zdroj:	Journal of thoracic disease [J Thorac Dis] 2022 Apr; Vol. 14 (4), pp. 822-831.
DOI:	10.21037/jtd-21-1178
Abstrakt:	Background: Pneumonia after thoracic surgery considerably contributes to perioperative morbidity and mortality. So far, the forced expiratory volume in one second and diffusing capacity of the lungs for carbon dioxide are the most common validated prognosticators to estimate individual risk. Beyond functional parameters, modifiable risk factors for respiratory complications like pneumonia are poorly investigated in a prospective way. Thus, we aimed to assess the impact of oral health status in patients undergoing thoracic surgery and its correlation to perioperative outcomes. Methods: A prospective observational study included adult patients undergoing elective thoracic surgery from October 2, 2018 to April 29, 2020. The day before surgery, patients were examined by a dentist. Oral health status (caries, periodontal disease, tooth loss, and regular dental visits) was correlated with perioperative outcomes. Results: During the study period, 230 consecutive patients were included. Oral health status was poor in the study population. Postoperative complications were associated with active caries [odds ratio (OR) 2.5, P<0.03]. Patients with frequent dental visits and treated teeth had a lower risk for postoperative complications compared with patients without regular visits (OR 0.3, P<0.02). Patients with a high burden of caries had a significantly increased risk for pneumonia (OR 7.9, P<0.002). The forced expiratory volume in one second was a significant prognosticator for postoperative complications; however, no association between the forced expiratory volume in one second and oral health parameters was observed. Conclusions: A pathological oral health status is a modifiable factor predicting postoperative complications and pneumonia. A prospective randomized interventional study is warranted to clarify whether an improvement in oral health status can lead to a reduction of perioperative risk. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-21-1178/coif). KD reports receiving different fees for research/lectures/consulting, but all issues are not related to this study. The other authors have no conflicts of interest to declare. (2022 Journal of Thoracic Disease. All rights reserved.)
Databáze:	MEDLINE
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