Abstract
AimWe conducted a multicenter study to explore the risk factors of developing pneumonia and the effectiveness of perioperative oral management (POM) for the prevention of pneumonia in postsurgical patients.Methods and resultsA survey covering eight regional hospitals was conducted over 4 years, from April 2010 to March 2014. Using the Diagnosis Procedure Combination database, a target group of 25,554 patients with cancer who underwent surgery was selected and assessed from a population of 346,563 patients without pneumonia on admission (sample population). The study compared the incidence of pneumonia and attempted to identify the significant predictive factors for its occurrence in these patients using multiple logistic regression analysis. Comparative assessment for the occurrence of pneumonia before and after POM implementation showed a significant incidence decrease after POM introduction in the target group, with no such change observed in the sample population. Multiple logistic regression analysis showed that the odds ratio for pneumonia occurrence after POM introduction was 0.44, indicating a reduced risk of pneumonia.ConclusionPOM in cancer patients was indeed effective in reducing the incidence of pneumonia in hospitals and thereby helped in preventing pneumonia during hospitalization.
Highlights
Pneumonia is a common and sometimes fatal complication following major cancer surgery
Perioperative oral management (POM) in cancer patients was effective in reducing the incidence of pneumonia in hospitals and thereby helped in preventing pneumonia during hospitalization
Several studies have shown that perioperative oral care may help prevent complications such as pneumonia and surgical site infection after cancer surgery.(Hong, Gueiros, Fulton, et al, 2019; Ishimaru et al, 2018; Nishikawa et al, 2019; Sato et al, 2011; Soutome et al, 2017) as these were small-scale studies and high-evidence-level studies are limited, it remains unclear whether POM can reduce pneumonia incidence.(Aoyama & Tamagawa, 2019)
Summary
Pneumonia is a common and sometimes fatal complication following major cancer surgery. Perioperative oral management (POM) was introduced into the Japanese universal health insurance system in April 2012 to prevent postoperative complications such as pneumonia in cancer patients. POM refers to professional oral care provided by dentists or dental hygienists and involves pretreatment evaluation of oral hygiene and administration of appropriate oral care and dental treatment in cases of high risk of infection. Several studies have shown that perioperative oral care may help prevent complications such as pneumonia and surgical site infection after cancer surgery.(Hong, Gueiros, Fulton, et al, 2019; Ishimaru et al, 2018; Nishikawa et al, 2019; Sato et al, 2011; Soutome et al, 2017) as these were small-scale studies and high-evidence-level studies are limited, it remains unclear whether POM can reduce pneumonia incidence.(Aoyama & Tamagawa, 2019).
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