TY - JOUR

T1 - The impact of oral diseases in cirrhosis on complications and mortality

AU - Grønkjær, Lea Ladegaard

AU - Holmstrup, Palle

AU - Jepsen, Peter

AU - Vilstrup, Hendrik

PY - 2021

Y1 - 2021

N2 - Background and Aim: The aims of this study were to describe the prevalence of various oral diseases and to examine the association of the oral diseases with complications and mortality of cirrhosis. Methods: A total of 184 cirrhosis patients were enrolled and were followed up for 2 years. They underwent oral clinical and radiographic examination. At study entry, the associations between oral diseases with nutrition, inflammation, and cirrhosis complication status were examined. Then, the associations of oral diseases with all-cause and cirrhosis-related mortality were examined using Cox regression to adjust for confounding by age, gender, smoking, alcohol use, alcoholic cirrhosis, cirrhosis complications, comorbidity, Child-Pugh, and Model of End-Stage Liver Disease (MELD) score. Results: At entry, 26% of the patients had gross caries, 46% periapical lesions, 27% oral mucosal lesions, and 68% periodontitis. Having one or more oral diseases was associated with a higher prevalence of cirrhosis complications (46.7 vs 20.5%), higher C-reactive protein (28.5 mg/L vs 10.4 mg/L), and higher nutritional risk score (4 vs 3). Two-thirds of the patients died during follow-up. The patients with more than one oral disease had an increasingly higher all-cause mortality (two diseases: hazard ratio [HR] 1.55, 95% confidence interval [CI] 1.02–1.98; three and four diseases: HR 1.75, 95% CI 1.05–3.24) and even higher cirrhosis-related mortality (two diseases: HR 1.60, 95% CI 1.01–2.40; three and four diseases: HR 2.04, 95% CI 1.05–8.83) compared to those with no oral disease. Conclusion: In cirrhosis, having more than one oral disease was associated with more complications and with higher mortality.

AB - Background and Aim: The aims of this study were to describe the prevalence of various oral diseases and to examine the association of the oral diseases with complications and mortality of cirrhosis. Methods: A total of 184 cirrhosis patients were enrolled and were followed up for 2 years. They underwent oral clinical and radiographic examination. At study entry, the associations between oral diseases with nutrition, inflammation, and cirrhosis complication status were examined. Then, the associations of oral diseases with all-cause and cirrhosis-related mortality were examined using Cox regression to adjust for confounding by age, gender, smoking, alcohol use, alcoholic cirrhosis, cirrhosis complications, comorbidity, Child-Pugh, and Model of End-Stage Liver Disease (MELD) score. Results: At entry, 26% of the patients had gross caries, 46% periapical lesions, 27% oral mucosal lesions, and 68% periodontitis. Having one or more oral diseases was associated with a higher prevalence of cirrhosis complications (46.7 vs 20.5%), higher C-reactive protein (28.5 mg/L vs 10.4 mg/L), and higher nutritional risk score (4 vs 3). Two-thirds of the patients died during follow-up. The patients with more than one oral disease had an increasingly higher all-cause mortality (two diseases: hazard ratio [HR] 1.55, 95% confidence interval [CI] 1.02–1.98; three and four diseases: HR 1.75, 95% CI 1.05–3.24) and even higher cirrhosis-related mortality (two diseases: HR 1.60, 95% CI 1.01–2.40; three and four diseases: HR 2.04, 95% CI 1.05–8.83) compared to those with no oral disease. Conclusion: In cirrhosis, having more than one oral disease was associated with more complications and with higher mortality.

KW - cirrhosis

KW - disease course

KW - mortality

KW - oral diseases

KW - oral health

U2 - 10.1002/jgh3.12489

DO - 10.1002/jgh3.12489

M3 - Journal article

C2 - 33553670

AN - SCOPUS:85099236859

VL - 5

SP - 294

EP - 300

JO - JGH Open

JF - JGH Open

SN - 2397-9070

IS - 2

ER -