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剩余牙齿数量与心脏瓣膜手术患者术后呼吸系统并发症的关系。

Association of remaining tooth number with postoperative respiratory complications in heart valve surgery patients.

机构信息

Division of Clinical Technology, Kagoshima University Hospital, Kagoshima, Japan.

Department of Preventive Dentistry, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.

出版信息

Int J Dent Hyg. 2024 May;22(2):394-400. doi: 10.1111/idh.12673. Epub 2023 Feb 21.

Abstract

OBJECTIVES

This study examined the association between the number of remaining teeth and the incidence of postoperative respiratory complications in patients undergoing heart valve surgery.

METHODS

We retrospectively enrolled 157 patients who underwent heart valve surgery between April 2010 and March 2019. Data on patient characteristics including systemic and oral conditions were extracted and postoperative respiratory complications were set as outcomes. Patients were divided into two groups according to the number of remaining teeth (≥20, <20). After adjusting for confounding factors with propensity scoring, logistic regression analysis was performed to examine the association of remaining teeth number with the incidence of postoperative respiratory complications. In addition, subgroup analysis was performed by stratifying the data into quintiles based on the propensity score.

RESULTS

Univariate analysis showed significant differences between the two groups in factors, including age, past cardiac surgery experience, New York Heart Association functional classification class IV, denture use, tooth extraction before surgery, occlusal support, and periodontitis. Logistic regression analysis showed that patients with <20 remaining teeth had a significantly higher incidence of postoperative respiratory complications than those with ≥20 remaining teeth, with an odds ratio of 29.800 (p = 0.004). Subgroup analysis showed that the odds ratio for the patients with <20 remaining teeth was 9.000 (p = 0.038).

CONCLUSIONS

The results suggest that heart valve surgery patients shall get attention on oral disease prevention by dental care practitioners to maintain a sufficient number of teeth for the prevention of postoperative respiratory complications.

摘要

目的

本研究旨在探讨心脏瓣膜手术后剩余牙齿数量与术后呼吸系统并发症发生的关系。

方法

我们回顾性纳入了 2010 年 4 月至 2019 年 3 月期间接受心脏瓣膜手术的 157 例患者。提取患者特征(包括全身和口腔状况)的数据,并将术后呼吸系统并发症作为结局。根据剩余牙齿数量(≥20 颗、<20 颗)将患者分为两组。采用倾向评分匹配调整混杂因素后,采用 logistic 回归分析剩余牙齿数量与术后呼吸系统并发症发生率的关系。此外,还根据倾向评分将数据分为五分位数进行亚组分析。

结果

单因素分析显示,两组间在年龄、既往心脏手术史、纽约心脏协会心功能分级Ⅳ级、使用义齿、术前拔牙、咬合支持和牙周炎等因素上存在显著差异。logistic 回归分析显示,剩余牙齿<20 颗的患者术后呼吸系统并发症的发生率显著高于剩余牙齿≥20 颗的患者,比值比为 29.800(p=0.004)。亚组分析显示,剩余牙齿<20 颗的患者比值比为 9.000(p=0.038)。

结论

研究结果表明,心脏瓣膜手术患者需要口腔疾病预防意识,通过口腔保健从业者保持足够数量的牙齿,以预防术后呼吸系统并发症。

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