Influence of Dental Status on Postoperative Complications in Major Visceral Surgical and Organ Transplantation Procedures - the BellyDent retrospective observational Study

Abstract

Abstract Background The significance of dental status and oral hygiene on a range of medical conditions is well-recognised. However, the correlation between periodontitis, oral bacterial dysbiosis and visceral surgical outcomes is less well established. To this end, we study sought to determine the influence of dental health and oral hygiene on the rates of postoperative complications following major visceral and transplant surgery in an exploratory, single-center, retrospective, non-interventional study.Methods This investigation was conducted at the Department of General, Visceral, and Transplant Surgery, University Hospital Heidelberg, Germany. Patients were retrospectively enrolled in the study based on inclusion and exclusion criteria. The final patient cohort consisted of 417 patients. A bacteriology examination was added whenever possible for infectious complications.Results There was significant association between oral health and the rate of infectious complications for all surgical procecdures, excluding transplant surgery. However, this did not result in increased 30-day mortality rates, prolonged intensive care unit treatment or an increase in the length of hospital stay (LOS) for the cohort as a whole. In contrast there was a significant correlation between the presence of oral pathogens and postoperative complications for a group as a whole and the visceral surgery subgroup. Whilst this was not the case in the cohort who underwent transplant surgery, there was a correlation between oral health and LOS in this subgroup. Bacterial swabs supports the link between poor oraI health and infectious morbidity.Conclusions Dental status was a significant predictor of postoperative infectious complications in this visceral surgery cohort but not in patient who underwent organ transplantation. The association did not translate into increased mortality rates, extended ICU treatment or increased LOS. This study highlights the importance preoperative dental assessment and treatment prior to major surgery, particularly in the case of elective surgical procedures. Further research is required to determine the effect of oral health on surgical outcomes in order to inform future practice.Trial registration trial registered under the ethics-number S-082/2022 (Ethic Committee of the University Heidelberg).