title: Hospital admissions for pneumonia more likely with concomitant dental infections.
abstract: OBJECTIVE
  The objective of this study is to determine if the presence of dental infection is associated with an increased likelihood of hospital admission following an emergency department (ED) visit among patients diagnosed with pneumonia. We hypothesized that the presence of a dental infection may worsen the clinical symptoms in ED patients diagnosed with pneumonia and are using hospital admission as a marker of worsening clinical severity.
  
  
  METHODS
  We analyzed the data from the 2008 Nationwide Emergency Department Sample and used Poisson regression with robust estimates of variance to obtain prevalence ratios (PRs) with the appropriate adjustments for complex survey sampling.
  
  
  RESULTS
  In the final multivariable model, there was a 19% increase in the likelihood of hospital admission following an ED visit among pneumonia patients diagnosed with dental infection compared to those without dental infection (PR = 1.19, 95% CI = 1.11-1.27). In an exploratory multivariable analysis, pneumonia patients diagnosed with dental caries had a 29% increase in the likelihood of admission compared to those not having dental caries (PR = 1.29, 95% CI = 1.23-1.34). These findings remained consistent in a subgroup analysis among patients with less clinically severe forms of pneumonia.
  
  
  CONCLUSIONS
  Dental infections may worsen the clinical symptoms in ED patients with pneumonia increasing their likelihood for hospital admission. Dental caries may be a marker for poor oral hygiene and increased dental plaque rather than serve directly as a source of respiratory pathogens.
  
  
  CONCLUSIONS
  The findings suggest that an increased focus on preventive oral health may reduce the need for admission following an ED visit for patients diagnosed with pneumonia.
authors.affiliation: Department of Restorative Services, Howard University College of Dentistry, Washington, DC, USA, brianlaurence2012@gmail.com.
authors.forename: Brian
authors.initials: B
authors.lastname: Laurence
authors.forename: Nee-Kofi
authors.initials: NK
authors.lastname: Mould-Millman
authors.forename: Frank A
authors.initials: FA
authors.lastname: Scannapieco
authors.forename: Armin
authors.initials: A
authors.lastname: Abron
mesh_terms: D000328:Adult; D000368:Aged; D004636:Emergency Service, Hospital; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007239:Infections / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000150:complications* / Q000453:epidemiology; D011014:Pneumonia / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors; D014481:United States / Q000453:epidemiology