Effect of perioperative oral management on postoperative bloodstream infection in heart valve surgery patients.

Abstract

There is a well-known relationship between oral hygiene and infective endocarditis. Epidemiological evidence regarding perioperative oral management (POM) for cancer surgery has been accumulated, but this evidence is not sufficient for cardiac surgery. Therefore, our purpose was to investigate whether POM can prevent postoperative complications in patients undergoing heart valve surgery. Using single-arm medical information, we retrospectively enrolled 301 patients who underwent heart valve surgery between April 2010 and March 2019. The patient background was adjusted by the propensity score (PS). We then analyzed the impact of POM on postoperative bloodstream infection (PBSI), postoperative pneumonia, and mortality using PS inverse probability of treatment weighting (IPTW). IPTW revealed that the POM group had a lower incidence of PBSI than the control group, with an odds ratio of 0.316 (p=0.003). The mortality in the POM group was significantly lower than that in the control group (p=0.023). Fourteen patients died in the present study and 6 of them were infection-related. POM was significantly associated with decreased incidence of PBSI and mortality. The results suggest that POM is beneficial for the prevention of PBSI and mortality in patients undergoing heart valve surgery.