Predictors of early postoperative pneumonia after oncologic surgery with the patients receiving professional oral health care: A prospective, multicentre, cohort study

Author:

Nozaki Shinichi1ORCID,Tsutsumi Yasuhiko2,Takasaki Yoshito3,Yoshikawa Hiromasa4,Shinya Toshiaki5,Souta Ruriko6,Nakamoto Norimichi7,Marukawa Kohei1,Usami Takeshi8,Sunami Jiro9,Takashima Maho10,Tanaka Kohji11,Nishizawa Rishiho12,Yanase Shigeaki13,Negoro Kenji14,Negishi Akihide15,Okumura Hidenori16,Otsuka Yoshiaki17,Honda Yasutoshi18,Otsuru Hiroshi19,Arika Takumi20,Nakashima Takeshi21,Nagasaka Hiroshi22,Watanabe Yuuko23,Kajiya Mikihito24,Senpuku Hidenobu25,Iwabuchi Hiroshi26

Affiliation:

1. Department of Dentistry and Oral Surgery, National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan

2. Department of Dentistry and Oral Surgery, National Hospital Organization Higashi-Ohmi General Medical Center, Higashi-Ohmi, Japan

3. Oral and Maxillo-Facial Surgery, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan

4. Department of Dentistry, Oral and Maxillofacial Surgery, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan

5. Department of Dentistry and Oral Surgery, National Hospital Organization Miyakonojo Medical Center, Miyakonojo, Japan

6. Department of Dentistry and Oral Surgery, National Hospital Organization Tochigi Medical Center, Utsunomiya, Japan

7. Department of Dentistry and Oral Surgery, National Hospital Organization Yonago Medical Center, Yonago, Japan

8. Department of Dentistry and Oral Surgery, National Hospital Organization Nagoya Medical Center, Nagoya, Japan

9. Department of Dentistry, National Hospital Organization Okayama Medical Center, Okayama, Japan

10. Department of Dentistry, National Hospital Organization Tokyo Hospital, Kiyose, Japan

11. Department of Dentistry and Oral Surgery, National Hospital Organization Kure Medical Canter/Chugoku Cancer Center, Kure, Japan

12. Nishizawa Dental Clinic, Ueda, Japan

13. Department of Dentistry and Oral Surgery, National Hospital Organization Mie Chuo Medical Center, Tsu, Japan

14. Department of Dentistry and Oral Surgery, National Hospital Organization Minami Wakayama Medical Center, Tanabe, Japan

15. Department of Oral and Maxillofacial Surgery, National Hospital Organization Yokohama Medical Center, Yokohama, Japan

16. Department of Dentistry and Oral Surgery, National Hospital Organization Higashinagoya National Hospital, Nagoya, Japan

17. Department of Dentistry, National Hospital Organization Chiba-East Hospital, Chiba, Japan

18. Department of Dentistry, National Hospital Organization Fukuyama Medical Center, Fukuyama, Japan

19. Department of Oral Surgery, National Hospital Organization Tokyo Medical Center, Meguro, Japan

20. Department of Oral and Maxilla-Facial Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan

21. Department of Dentistry and Oral Surgery, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan

22. Department of Dentistry and Oral Surgery, Sendai Aoba Clinic, Sendai, Japan

23. Department of Dentistry, National Hospital Organization Utsunomiya Hospital, Utsunomiya, Japan

24. Department of Dentistry, National Hospital Organization Higashihiroshima Medical Center, Higashihiroshima, Japan

25. Department of Bacteriology I, National Institute of Infectious Diseases, Shinjuku, Japan

26. Department of Dentomaxillofacial Diagnosis and Treatment, Division of Oral and Maxillofacial Surgery, Graduate School of Kanagawa Dental University, Yokosuka, Japan

Abstract

This study was a prospective, multicentre, cohort study on 685 patients who had undergone oncologic surgery. The patients were divided into two groups according to the presence or absence of postoperative pneumonia. The two groups were compared with respect to their background, index operation, food eaten, oral condition, contents of oral care and dental treatment, laboratory data, and bacterial flora. All postoperative pneumonias occurred in six cases within four days postoperatively. The multivariable logistic regression analysis showed that preoperative serum C-reactive protein was the strongest predictor of postoperative pneumonia. In addition, decreased postoperative Candida albicans colonies was an effective predictor of postoperative pneumonia. For patients with predictors of postoperative pneumonia, perioperative strategies for its prevention should be considered in addition to professional oral health care. This study was approved by the National Hospital Organization’s Central Ethics Review Board and was also approved by the directors of the participating institutions.

Funder

grants for National Hospital Organization Operating Expenses

Publisher

SAGE Publications

Subject

General Medicine

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