title: Impact of Periapical Abscess on Infectious Complications in Patients Undergoing Extracorporeal Circulation Auxiliary to Open-Heart Surgical Procedures.
abstract: OBJECTIVE
  Extracorporeal circulation auxiliary to open-heart surgeries (ECAOHS) may exert nonphysiological stresses on periapical abscessed tissues leading to hematogenous spread of microbes. The aim of this report was to estimate risk of postoperative infectious complications in patients with periapical abscesses and undergoing ECAOHS.
  
  
  METHODS
  A retrospective analysis of Nationwide Inpatient Sample (years 2009 and 2010) was conducted. All patients (aged 19 to 65 years) who underwent ECAOHS were selected. International Classification of Diseases-9-Clinical Modification codes were used to identify the presence of periapical abscess and infectious complications. Multivariable logistic regression models were used to examine the associations between the presence of periapical abscess and occurrence of infectious complications.
  
  
  RESULTS
  A total of 265,235 patients underwent an ECAOH procedure. Of these, 431 patients had a periapical abscess. Septicemia developed in 16% of those with periapical abscess (compared with 4.2% in those without periapical abscess). Those with periapical abscess had higher rates of any of the infectious complications when compared with those without periapical abscess (30.2% vs 11.6%, respectively). After adjustment for multiple confounders, those with periapical abscess were associated with higher odds for developing septicemia (odds ratio = 2.51, 95% confidence interval = 1.06-5.91, P = .04) and any of the infectious complications (odds ratio = 2.23, 95% confidence interval = 1.08-4.59, P = .03) when compared with those who did not have periapical abscess.
  
  
  CONCLUSIONS
  Those with periapical abscess are associated with higher odds for infectious complications when compared with those without periapical abscess.
authors.affiliation: Department of Orthodontics, College of Dentistry and Dental Clinics, The University of Iowa, Iowa City, IA, USA. Electronic address: Veerasathpurush-Allareddy@uiowa.edu.
authors.forename: Veerasathpurush
authors.initials: V
authors.lastname: Allareddy
authors.affiliation: Department of Periodontology, Oregon Health & Science University, Portland, OR, USA.
authors.forename: Sivaraman
authors.initials: S
authors.lastname: Prakasam
authors.affiliation: Health Services Research & Administration Department, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
authors.forename: Sankeerth
authors.initials: S
authors.lastname: Rampa
authors.affiliation: Department of Oral and Maxillofacial Surgery, College of Dentistry and Dental Clinics, The University of Iowa, Iowa City, IA, USA.
authors.forename: Kyle
authors.initials: K
authors.lastname: Stein
authors.affiliation: Department of Cariology, Restorative Sciences, and Endodontics, Office of Patient Services, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
authors.forename: Romesh P
authors.initials: RP
authors.lastname: Nalliah
authors.affiliation: Division of Critical Care, Stead Family Department of Pediatrics, University of Iowa Children's Hospital, Iowa City, IA, USA.
authors.forename: Veerajalandhar
authors.initials: V
authors.lastname: Allareddy
authors.affiliation: Department of Orthodontics and Dentofacial Orthopedics, University of Missouri, Kansas City School of Dentistry, Kansas City, MO, USA.
authors.forename: Shankar
authors.initials: S
authors.lastname: Rengasamy Venugopalan
mesh_terms: D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures; D005112:Extracorporeal Circulation; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D010482:Periapical Abscess; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Abscesses; Cardiovascular diseases; Outcome assessment; Surgical procedures