title: Preventive Effect on Post-Operative Pneumonia of Oral Health Care among Patients Who Undergo Esophageal Resection: A Multi-Center Retrospective Study.
abstract: BACKGROUND
  Post-operative pneumonia is a frequent and possibly fatal complication of esophagectomy and is likely caused by aspiration of oropharyngeal fluid that contains pathogenic micro-organisms. We conducted a multi-center retrospective study to investigate the preventive effect of oral health care on post-operative pneumonia among patients with esophageal cancer who underwent esophagectomy.
  
  
  METHODS
  A total of 280 patients underwent esophagectomy at three university hospitals. These patients were divided retrospectively into those who received pre-operative oral care from dentists and dental hygienists (oral care group; n = 173) and those who did not receive such care (control group; n = 107). We evaluated the correlations between the occurrence of post-operative pneumonia and 18 predictive variables (patient factors, tumor factors, treatment factors, and pre-operative oral care) using the χ(2) test and logistic regression analysis. The differences of mean hospital days and mortality rate in both groups were analyzed by the Student t-test.
  
  
  RESULTS
  Age, post-operative dysphagia, and absence of pre-operative oral care were correlated significantly with post-operative pneumonia in the univariable analysis. Multivariable analysis revealed that diabetes mellitus, post-operative dysphagia, and the absence of pre-operative oral care were independent risk factors for post-operative pneumonia. The mean hospital stay and mortality rate did not differ between the oral care and control groups.
  
  
  CONCLUSIONS
  Pre-operative oral care may be an effective and easy method to prevent post-operative pneumonia in patients who are undergoing esophagectomy.
authors.affiliation: 1 Perioperative Oral Management Center, Nagasaki University Hospital , Nagasaki, Japan .
authors.forename: Sakiko
authors.initials: S
authors.lastname: Soutome
authors.affiliation: 2 Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki, Japan .
authors.forename: Souichi
authors.initials: S
authors.lastname: Yanamoto
authors.affiliation: 2 Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki, Japan .
authors.forename: Madoka
authors.initials: M
authors.lastname: Funahara
authors.affiliation: 3 Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine , Kobe, Japan .
authors.forename: Takumi
authors.initials: T
authors.lastname: Hasegawa
authors.affiliation: 3 Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine , Kobe, Japan .
authors.forename: Takahide
authors.initials: T
authors.lastname: Komori
authors.affiliation: 4 Department of Preventive Dentistry, Kagoshima University Graduate School of Medical and Dental Sciences , Kagoshima, Japan .
authors.forename: Takahiko
authors.initials: T
authors.lastname: Oho
authors.affiliation: 2 Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki, Japan .
authors.forename: Masahiro
authors.initials: M
authors.lastname: Umeda
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009909:Oral Health; D009910:Oral Hygiene / Q000379:methods; D011014:Pneumonia / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies