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Risk factors for postoperative pneumonia according to examination findings before surgery under general anesthesia

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Abstract

Objective

This study was performed to determine the risk factors associated with postoperative complications after surgery under general anesthesia according to respiratory function test results and oral conditions.

Materials and methods

Preoperative examination data were collected for 471 patients who underwent surgery under general anesthesia at the Medical Hospital of Kyusyu University. Respiratory function tests, oral examinations, and perioperative oral management were performed in all patients. The incidence of and risk factors for postoperative complications were investigated. Classification and regression tree analyses were performed to investigate the risk factors for postoperative complications.

Results

Among the 471 patients, 11 developed postoperative pneumonia, 10 developed postoperative respiratory symptoms, and 10 developed postoperative fever. The most important risk factor for pneumonia was edentulism. Age, the Brinkman index, and head and neck surgery were also revealed as important risk factors for pneumonia. The O’Leary plaque control record (initial visit) was an important risk factor for postoperative respiratory symptoms. With respect to postoperative fever, a Hugh–Jones classification of grade > 1 was the most important risk factor; edentulism and a Brinkman index of > 642.5 were also found to be risk factors.

Conclusion

In addition to respiratory function tests, oral examinations may be important for the prediction of postoperative complications. Additionally, improved oral hygiene may be effective in preventing postoperative respiratory complications.

Clinical relevance

Risk factors for postoperative complications should be comprehensively evaluated using both respiratory function tests and oral findings.

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Acknowledgments

We thank Angela Morben, DVM, ELS, from Edanz Group (www.edanzediting.com/ac), for editing a draft of this manuscript.

Funding

The study was self-funded, and no external funding was received by any of the authors.

Author information

Authors and Affiliations

  1. Division of General Dentistry, Kyushu University Hospital, Kyushu University, Fukuoka, Japan

    Yuko Inai, Tohru Takarada & Naohisa Wada

  2. Department of Translational Research, School of Dental Medicine, Tsurumi University, Yokohama, Japan

    Yoshiaki Nomura & Nobuhiro Hanada

Authors
  1. Yuko Inai
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  2. Yoshiaki Nomura
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  3. Tohru Takarada
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  4. Nobuhiro Hanada
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  5. Naohisa Wada
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Corresponding author

Correspondence to Yuko Inai.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (include name of committee + reference number) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The protocol was approved by the Institutional Review Board of Kyushu University Hospital (approval number: 29-278).

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Written informed consent was obtained from all individual participants included in the study.

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Inai, Y., Nomura, Y., Takarada, T. et al. Risk factors for postoperative pneumonia according to examination findings before surgery under general anesthesia. Clin Oral Invest 24, 3577–3585 (2020). https://doi.org/10.1007/s00784-020-03230-7

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  • DOI: https://doi.org/10.1007/s00784-020-03230-7

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