Cardiovascular Disease, Heart Valve Disease, Periodontitis, Postoperative Infection
Conditions
Keywords
Preoperative Periodontal Treatment, Cardiac Valve Surgery, Periodontal Disease, Postoperative Infection, Retrospective Study
Brief summary
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.
Detailed description
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.
Interventions
None listed
Sponsors
Istanbul University - Cerrahpasa
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult patients (≥18 years) who underwent cardiac valve surgery * Availability of preoperative panoramic radiographs * Complete medical and dental records, including DMFT index and systemic clinical parameters * Patients with documented postoperative clinical follow-up data
Exclusion criteria
* Patients under 18 years of age * Patients with incomplete or missing medical or radiographic records * Patients with a history of systemic conditions severely affecting bone metabolism (e.g., advanced malignancy, metabolic bone disease) * Patients who received recent periodontal treatment prior to radiographic assessment * Poor-quality radiographs that do not allow accurate evaluation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Radiographic Alveolar Bone Loss Percentage Assessed on Panoramic Radiographs | Preoperative assessment (baseline) | 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. |
| Periodontal disease diagnosis (presence and severity) | Preoperative assessment (baseline) | Periodontal disease diagnosed based on radiographic findings and classified according to established periodontal disease criteria (e.g., mild, moderate, or severe periodontitis). |
| DMFT index (Decayed, Missing, Filled Teeth score) | Preoperative assessment (baseline) | The DMFT index calculated from radiographic and clinical records to quantify cumulative dental caries experience in each patient. |
| Postoperative infection-related clinical outcomes (fever duration) | Measured within the first 7 postoperative days following cardiac surgery. | The number of days with postoperative fever (≥37.5°C) recorded from patient medical records and used as an indicator of postoperative infection. |
| Length of postoperative hospital stay (days) | From the date of cardiac surgery until hospital discharge, assessed up to 30 days postoperatively. | 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. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Duration of intensive care unit (ICU) stay (days) | From admission to the intensive care unit following cardiac surgery until ICU discharge, assessed up to 30 days postoperatively. | The number of days spent in the intensive care unit following cardiac surgery recorded and analyzed according to preoperative oral and periodontal health status. |
| Time to initiation of oral feeding (days) | From the date of cardiac surgery until initiation of oral feeding, assessed up to 30 days postoperatively. | The number of days from cardiac surgery to the initiation of oral feeding recorded and evaluated as an indicator of postoperative recovery. |
| Postoperative C-Reactive Protein (CRP) Level | Measured within the first 7 postoperative days following cardiac surgery. | 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. |
| Postoperative White Blood Cell (WBC) Count | Measured within the first 7 postoperative days following cardiac surgery. | 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. |
Countries
Turkey (Türkiye)
Outcome results
None listed