Chronic periodontitis and community-acquired pneumonia: a population-based cohort study

Seon-Jip Kim,Sung Min Kim,Sang Min Park,Seulggie Choi,Hyun-Jae Cho,Kyuwoong Kim,Jooyoung Chang

doi:10.1186/s12890-019-1017-1

Abstract

BackgroundThis study aimed to determine the association between chronic periodontitis (CP) and community-acquired pneumonia (CAP) according to CP severity in the Korean population based on the National Health Insurance Service database.MethodsData from the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS), conducted from 2002 to 2013, were analyzed. A total of 363,541 participants were enrolled in this retrospective cohort study. Data on socio-demographic characteristics and CAP-related variables were collected. Participants were divided into 4 groups according to CP severity. Cox proportional hazards regression was performed after adjusting for sociodemographic and related covariates.ResultsA total of 363,541 participants were included in the analysis. The number of CAP cases in the index period was 14,838 (4.1%). Among the 4 groups, the mean age was significantly higher in the severe CP group. The incidence rates of severe and non-severe CP were 5.68 and 4.99, respectively (per 103 person-years). The hazard ratio for CAP was not significant in any of the models regardless of the presence or absence of CP. On stratification analysis by sex, smoking and Charlson comorbidity index, there were no significant differences between CAP and CP in any of the models.ConclusionThe results of this study show that CP may not be a potential risk factor for CAP.

Highlights

This study aimed to determine the association between chronic periodontitis (CP) and communityacquired pneumonia (CAP) according to CP severity in the Korean population based on the National Health Insurance Service database
hospitalacquired pneumonia (HAP) refers to pneumonia that develops 48 h after admission or within 10 days after discharge from a hospital without incubation [8], and CAP refers to an acute infection of the lungs in individuals who have not been recently hospitalized and are not regularly exposed to the healthcare system [9]
A total of 363,541 participants were followed for an average of 7.6 years, resulting in 2, 782,453 person-years

Summary

Introduction

This study aimed to determine the association between chronic periodontitis (CP) and communityacquired pneumonia (CAP) according to CP severity in the Korean population based on the National Health Insurance Service database. Periodontal disease is a chronic inflammatory disease of the periodontal tissue that affects approximately 20 to 50% of the world’s population [1]. It is caused by colonization of periapical periodontal pathogens that cause destruction of the ligaments and alveolar bone supporting the teeth [2, 3]. Research has suggested that periodontal disease is a Pneumonia is one of the most common serious infections and causes significant morbidity and mortality in both healthy and vulnerable individuals [7]. According to data from the Korea National Statistical Office, pneumonia was the 10th leading cause of

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