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This retrospective observational study aims to evaluate the effect of preoperative periodontal treatment on postoperative infection and mortality in patients undergoing aortic and mitral valve surgery.
Patient records between 2015 and 2024 analyzed. Demographic, clinical, and and radiographic findings, evaluated. Postoperative outcomes such as infection, antibiotic use, length of hospital and intensive care unit stay, and mortality assessed.
The findings of this study may contribute to understanding the role of periodontal health in improving postoperative outcomes in cardiac surgery patients.
Periodontitis is a chronic inflammatory disease that has been associated with various systemic conditions, including cardiovascular diseases and infective endocarditis. Oral pathogens and inflammatory mediators originating from periodontal tissues may enter the bloodstream and contribute to systemic inflammation and postoperative complications.
This retrospective observational study includes patients aged 18 years and older who underwent aortic and mitral valve surgery and received or not periodontal treatment within 15 days prior to surgery. Patient records from 2015 to 2024 has been reviewed. Inclusion and exclusion criteria has been applied to ensure data consistency and reliability.
Collected data included demographic characteristics, medical history, periodontal disease stages, DMFT scores, and radiographic findings. Postoperative variables such as infection status, antibiotic use, duration of hospitalization, intensive care unit stay, and mortality has been evaluated.
Statistical analyses performed using appropriate parametric and non-parametric tests. Multivariate regression models used to identify factors associated with postoperative infection and mortality.
The aim of this study is to determine whether preoperative periodontal treatment has a significant impact on postoperative outcomes in patients undergoing cardiac valve surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Elective Surgery Patients | This cohort includes patients who underwent elective aortic or mitral valve surgery and had complete medical and dental records available. All patients received standard preoperative evaluation, and those with documented periodontal treatment within 15 days prior to surgery were included. | ||
| Emergency Surgery Patients | This cohort consists of patients who underwent emergency aortic or mitral valve surgery. Due to the urgent nature of the procedure, preoperative periodontal assessment and treatment not have been consistently performed. |
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| Measure | Description | Time Frame |
|---|---|---|
| Radiographic Alveolar Bone Loss Percentage Assessed on Panoramic Radiographs | Radiographic periodontal bone loss have been assessed on panoramic radiographs by measuring the percentage of alveolar bone loss relative to root length. Bone loss severity will be categorized according to the extent of radiographic alveolar bone loss. Higher percentages indicate greater periodontal destruction and more severe periodontal disease. | Preoperative assessment (baseline) |
| Periodontal disease diagnosis (presence and severity) | Periodontal disease diagnosed based on radiographic findings and classified according to established periodontal disease criteria (e.g., mild, moderate, or severe periodontitis). | Preoperative assessment (baseline) |
| DMFT index (Decayed, Missing, Filled Teeth score) | The DMFT index calculated from radiographic and clinical records to quantify cumulative dental caries experience in each patient. | Preoperative assessment (baseline) |
| Postoperative infection-related clinical outcomes (fever duration) | The number of days with postoperative fever (≥37.5°C) recorded from patient medical records and used as an indicator of postoperative infection. | Measured within the first 7 postoperative days following cardiac surgery. |
| Length of postoperative hospital stay (days) | The duration of hospitalization has been recorded in days from the date of cardiac surgery until hospital discharge and compared according to preoperative oral and periodontal status. | From the date of cardiac surgery until hospital discharge, assessed up to 30 days postoperatively. |
| Measure | Description | Time Frame |
|---|---|---|
| Duration of intensive care unit (ICU) stay (days) | The number of days spent in the intensive care unit following cardiac surgery recorded and analyzed according to preoperative oral and periodontal health status. | From admission to the intensive care unit following cardiac surgery until ICU discharge, assessed up to 30 days postoperatively. |
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Inclusion Criteria:
Exclusion Criteria:
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This retrospective study population consists of adult patients who underwent cardiac valve surgery and had available preoperative panoramic radiographs and complete clinical records. The study aims to evaluate the association between oral health status (DMFT index and radiographic periodontal condition) and postoperative clinical outcomes.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Bakirköy Dr. Sadi Konuk Education and Research Hospital | Istanbul | Bakirköy | 34147 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19121072 | Result | Nakano K, Nemoto H, Nomura R, Inaba H, Yoshioka H, Taniguchi K, Amano A, Ooshima T. Detection of oral bacteria in cardiovascular specimens. Oral Microbiol Immunol. 2009 Feb;24(1):64-8. doi: 10.1111/j.1399-302X.2008.00479.x. | |
| 22244863 | Result | Sfyroeras GS, Roussas N, Saleptsis VG, Argyriou C, Giannoukas AD. Association between periodontal disease and stroke. J Vasc Surg. 2012 Apr;55(4):1178-84. doi: 10.1016/j.jvs.2011.10.008. Epub 2012 Jan 14. |
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De-identified participant data including questionnaire responses and periodontal measurements will be available upon reasonable request after publication.
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| Time to initiation of oral feeding (days) |
The number of days from cardiac surgery to the initiation of oral feeding recorded and evaluated as an indicator of postoperative recovery. |
| From the date of cardiac surgery until initiation of oral feeding, assessed up to 30 days postoperatively. |
| Postoperative C-Reactive Protein (CRP) Level | Serum C-reactive protein (CRP) concentration, measured in milligrams per liter (mg/L), obtained from medical records and analyzed as an indicator of postoperative systemic inflammatory response. Higher values indicate a greater inflammatory response. | Measured within the first 7 postoperative days following cardiac surgery. |
| Postoperative White Blood Cell (WBC) Count | White blood cell count, measured in ×10⁹ cells/L, obtained from medical records and analyzed as an indicator of postoperative systemic inflammatory response. Higher values indicate a greater inflammatory response. | Measured within the first 7 postoperative days following cardiac surgery. |
| 24934646 | Result | Saengtipbovorn S, Taneepanichskul S. Effectiveness of lifestyle change plus dental care (LCDC) program on improving glycemic and periodontal status in the elderly with type 2 diabetes. BMC Oral Health. 2014 Jun 16;14:72. doi: 10.1186/1472-6831-14-72. |
| 28315732 | Result | Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Fleisher LA, Jneid H, Mack MJ, McLeod CJ, O'Gara PT, Rigolin VH, Sundt TM 3rd, Thompson A. 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2017 Jul 11;70(2):252-289. doi: 10.1016/j.jacc.2017.03.011. Epub 2017 Mar 15. No abstract available. |
| 25534621 | Result | Hajishengallis G. Periodontitis: from microbial immune subversion to systemic inflammation. Nat Rev Immunol. 2015 Jan;15(1):30-44. doi: 10.1038/nri3785. |
| 19563632 | Result | Bagyi K, Haczku A, Marton I, Szabo J, Gaspar A, Andrasi M, Varga I, Toth J, Klekner A. Role of pathogenic oral flora in postoperative pneumonia following brain surgery. BMC Infect Dis. 2009 Jun 29;9:104. doi: 10.1186/1471-2334-9-104. |
| ID | Term |
|---|---|
| D010518 | Periodontitis |
| D006349 | Heart Valve Diseases |
| D002318 | Cardiovascular Diseases |
| D010510 | Periodontal Diseases |
| ID | Term |
|---|---|
| D009059 | Mouth Diseases |
| D009057 | Stomatognathic Diseases |
| D006331 | Heart Diseases |
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