Eiji Iwata1, Takumi Hasegawa2, Shin-Ichi Yamada3, Yumiko Kawashita4, Masako Yoshimatsu4, Tomomi Mizutani5, Hirokazu Nakahara6, Kazuyo Mori7, Yasuyuki Shibuya5, Hiroshi Kurita3, Takahide Komori8. 1. Department of Oral and Maxillofacial Surgery, Kakogawa Central City Hospital, Kakogawa, Japan; Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Japan. 2. Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Japan. Electronic address: hasetaku@med.kobe-u.ac.jp. 3. Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Nagano, Japan. 4. Perioperative Oral Management Center, Nagasaki University Hospital, Japan. 5. Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Nagoya City University, Japan. 6. Department of Oral and Maxillofacial Surgery, Osaka City University Graduate School of Medicine, Japan. 7. Section of Oral Hygiene, Kagoshima University Hospital, Japan. 8. Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Japan.
Abstract
BACKGROUND: Postoperative pneumonia can be a fatal complication that may occur after lung resection in cancer patients. Some reports have shown that the incidence of postoperative pneumonia is decreased after esophageal surgery by perioperative oral care; however, there exist no data to suggest that a lack of perioperative oral care can be a risk factor for postoperative pneumonia after lung resection. To investigate the association between the preventive effect of oral care and postoperative pneumonia, we conducted a multicenter, retrospective study of lung cancer patients who underwent lung resection. METHODS: Between January 2014 and December 2016, a total of 721 patients underwent lung resections at 1 of the 6 hospitals included in our study. Among 721 patients, 280 (38.8%) received perioperative oral care, and the remaining 441 (61.2%) did not receive any such care. Propensity score matching was performed to minimize selection biases associated with the comparison of retrospective data between the oral care and control groups. RESULTS: Of the 721 patients, 54 (7.5%) experienced postoperative pneumonia involving 13 of the 280 patients (4.6%) in the oral care group and 41 of the 441 patients (9.3%) in the control group (P = .02). On propensity score analysis, a significant difference was also found between oral care intervention and incidence of postoperative pneumonia (P = .002). CONCLUSION: Our results suggest that perioperative oral care is an effective method to decrease the occurrence of postoperative pneumonia in patients who have undergone lung resection.
BACKGROUND:Postoperative pneumonia can be a fatal complication that may occur after lung resection in cancerpatients. Some reports have shown that the incidence of postoperative pneumonia is decreased after esophageal surgery by perioperative oral care; however, there exist no data to suggest that a lack of perioperative oral care can be a risk factor for postoperative pneumonia after lung resection. To investigate the association between the preventive effect of oral care and postoperative pneumonia, we conducted a multicenter, retrospective study of lung cancerpatients who underwent lung resection. METHODS: Between January 2014 and December 2016, a total of 721 patients underwent lung resections at 1 of the 6 hospitals included in our study. Among 721 patients, 280 (38.8%) received perioperative oral care, and the remaining 441 (61.2%) did not receive any such care. Propensity score matching was performed to minimize selection biases associated with the comparison of retrospective data between the oral care and control groups. RESULTS: Of the 721 patients, 54 (7.5%) experienced postoperative pneumonia involving 13 of the 280 patients (4.6%) in the oral care group and 41 of the 441 patients (9.3%) in the control group (P = .02). On propensity score analysis, a significant difference was also found between oral care intervention and incidence of postoperative pneumonia (P = .002). CONCLUSION: Our results suggest that perioperative oral care is an effective method to decrease the occurrence of postoperative pneumonia in patients who have undergone lung resection.
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