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Secondary analysis of potential associations between oral health and infection-related parameters in patients with severe heart failure—results of a German cohort

OBJECTIVES: Aim of this retrospective cohort study was to evaluate whether oral health parameters would be associated with infection-related parameters and overall survival of patients with severe heart failure (HF). METHODS: Patients with severe HF, heart transplantation (HTx) and left-ventricular...

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Autores principales: Schmalz, Gerhard, Hennecke, Alina, Haak, Rainer, Kottmann, Tanja, Garbade, Jens, Binner, Christian, Ziebolz, Dirk
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10664670/
https://www.ncbi.nlm.nih.gov/pubmed/37990175
http://dx.doi.org/10.1186/s12872-023-03612-1
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author Schmalz, Gerhard
Hennecke, Alina
Haak, Rainer
Kottmann, Tanja
Garbade, Jens
Binner, Christian
Ziebolz, Dirk
author_facet Schmalz, Gerhard
Hennecke, Alina
Haak, Rainer
Kottmann, Tanja
Garbade, Jens
Binner, Christian
Ziebolz, Dirk
author_sort Schmalz, Gerhard
collection PubMed
description OBJECTIVES: Aim of this retrospective cohort study was to evaluate whether oral health parameters would be associated with infection-related parameters and overall survival of patients with severe heart failure (HF). METHODS: Patients with severe HF, heart transplantation (HTx) and left-ventricular assist device (LVAD), which underwent a full oral examination between 2017 and 2018 were included. Infection-related and survival data were assessed from the patient´s medical records. The oral examination included: remaining teeth, caries and periodontal condition, including periodontal probing depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), and diagnosis (staging/grading). In addition, the periodontal inflamed surface area (PISA) was determined. Statistical analysis included Chi-square, Fisher´s exact and Mann-Whitney-U test, as well as a logistic regression, considering age, gender, body-mass-index (BMI), diabetes and several oral health parameters with regard to overall survival and infections at heart/driveline. RESULTS: 329 patients (HTx: 34%, LVAD: 38.9%, HF: 27.1%), were included. Patients had on average 18.96 ± 8.90 remaining teeth, whereby the majority had a periodontitis stage III or IV (88.7%) and a grade B (80.5%). Higher BOP was associated with infections at heart/driveline (p = 0.04) and outside the heart (p < 0.01) during follow-up. Increased PISA was significantly associated with bacterial infections outside the heart (p < 0.01) and sepsis (p = 0.02). Only BMI of 25 or higher correlated with an increased risk of infections at heart/driveline in regression analysis (OR 3.063, CI(95) 1.158–8.101, p = 0.02), while no associations between oral health parameters and infections at heart/driveline or overall survival were confirmed. CONCLUSIONS: In patients with severe HF, periodontal inflammation might be associated with infection-related parameters. Improved dental care, especially including periodontal therapy and maintenance might be favourable to support prevention of infections in patients with severe HF. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12872-023-03612-1.
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spelling pubmed-106646702023-11-21 Secondary analysis of potential associations between oral health and infection-related parameters in patients with severe heart failure—results of a German cohort Schmalz, Gerhard Hennecke, Alina Haak, Rainer Kottmann, Tanja Garbade, Jens Binner, Christian Ziebolz, Dirk BMC Cardiovasc Disord Research OBJECTIVES: Aim of this retrospective cohort study was to evaluate whether oral health parameters would be associated with infection-related parameters and overall survival of patients with severe heart failure (HF). METHODS: Patients with severe HF, heart transplantation (HTx) and left-ventricular assist device (LVAD), which underwent a full oral examination between 2017 and 2018 were included. Infection-related and survival data were assessed from the patient´s medical records. The oral examination included: remaining teeth, caries and periodontal condition, including periodontal probing depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), and diagnosis (staging/grading). In addition, the periodontal inflamed surface area (PISA) was determined. Statistical analysis included Chi-square, Fisher´s exact and Mann-Whitney-U test, as well as a logistic regression, considering age, gender, body-mass-index (BMI), diabetes and several oral health parameters with regard to overall survival and infections at heart/driveline. RESULTS: 329 patients (HTx: 34%, LVAD: 38.9%, HF: 27.1%), were included. Patients had on average 18.96 ± 8.90 remaining teeth, whereby the majority had a periodontitis stage III or IV (88.7%) and a grade B (80.5%). Higher BOP was associated with infections at heart/driveline (p = 0.04) and outside the heart (p < 0.01) during follow-up. Increased PISA was significantly associated with bacterial infections outside the heart (p < 0.01) and sepsis (p = 0.02). Only BMI of 25 or higher correlated with an increased risk of infections at heart/driveline in regression analysis (OR 3.063, CI(95) 1.158–8.101, p = 0.02), while no associations between oral health parameters and infections at heart/driveline or overall survival were confirmed. CONCLUSIONS: In patients with severe HF, periodontal inflammation might be associated with infection-related parameters. Improved dental care, especially including periodontal therapy and maintenance might be favourable to support prevention of infections in patients with severe HF. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12872-023-03612-1. BioMed Central 2023-11-21 /pmc/articles/PMC10664670/ /pubmed/37990175 http://dx.doi.org/10.1186/s12872-023-03612-1 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Schmalz, Gerhard
Hennecke, Alina
Haak, Rainer
Kottmann, Tanja
Garbade, Jens
Binner, Christian
Ziebolz, Dirk
Secondary analysis of potential associations between oral health and infection-related parameters in patients with severe heart failure—results of a German cohort
title Secondary analysis of potential associations between oral health and infection-related parameters in patients with severe heart failure—results of a German cohort
title_full Secondary analysis of potential associations between oral health and infection-related parameters in patients with severe heart failure—results of a German cohort
title_fullStr Secondary analysis of potential associations between oral health and infection-related parameters in patients with severe heart failure—results of a German cohort
title_full_unstemmed Secondary analysis of potential associations between oral health and infection-related parameters in patients with severe heart failure—results of a German cohort
title_short Secondary analysis of potential associations between oral health and infection-related parameters in patients with severe heart failure—results of a German cohort
title_sort secondary analysis of potential associations between oral health and infection-related parameters in patients with severe heart failure—results of a german cohort
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10664670/
https://www.ncbi.nlm.nih.gov/pubmed/37990175
http://dx.doi.org/10.1186/s12872-023-03612-1
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