TY - JOUR

T1 - Severe periodontitis and higher cirrhosis mortality

AU - Gronkjaer, Lea Ladegaard

AU - Holmstrup, Palle

AU - Schou, Søren

AU - Jepsen, Peter

AU - Vilstrup, Hendrik

PY - 2018

Y1 - 2018

N2 - BackgroundPeriodontitis and edentulism are prevalent in patients with cirrhosis, but their clinical significance is largely unknown.ObjectiveThe objective of this article is to determine the association of severe periodontitis and edentulism with mortality in patients with cirrhosis.MethodsA total of 184 cirrhosis patients underwent an oral examination. All-cause and cirrhosis-related mortality was recorded. The associations of periodontitis and edentulism with mortality were explored by Kaplan–Meier survival plots and Cox proportional hazards regression adjusted for age, gender, cirrhosis etiology, Child–Pugh score, Model for End-Stage Liver Disease score, smoker status, present alcohol use, comorbidity, and nutritional risk score.ResultsThe total follow-up time was 74,197 days (203.14 years). At entry, 44% of the patients had severe periodontitis and 18% were edentulous. Forty-four percent of the patients died during follow-up. Severe periodontitis was associated with higher all-cause mortality in the crude analysis (HR 1.56, 95% CI 1.06–2.54), but not in the adjusted analysis (HR 1.45, 95% CI 0.79–2.45). Severe periodontitis was even more strongly associated with higher cirrhosis-related mortality (crude HR 2.19, 95% CI 1.07–4.50 and adjusted HR 2.29, 95% CI 1.04–4.99). No association was found between edentulism and mortality.ConclusionThe presence of severe periodontitis predicted a more than double one-year cirrhosis mortality. These findings may motivate intervention trials on the effect of periodontitis treatment in patients with cirrhosis.

AB - BackgroundPeriodontitis and edentulism are prevalent in patients with cirrhosis, but their clinical significance is largely unknown.ObjectiveThe objective of this article is to determine the association of severe periodontitis and edentulism with mortality in patients with cirrhosis.MethodsA total of 184 cirrhosis patients underwent an oral examination. All-cause and cirrhosis-related mortality was recorded. The associations of periodontitis and edentulism with mortality were explored by Kaplan–Meier survival plots and Cox proportional hazards regression adjusted for age, gender, cirrhosis etiology, Child–Pugh score, Model for End-Stage Liver Disease score, smoker status, present alcohol use, comorbidity, and nutritional risk score.ResultsThe total follow-up time was 74,197 days (203.14 years). At entry, 44% of the patients had severe periodontitis and 18% were edentulous. Forty-four percent of the patients died during follow-up. Severe periodontitis was associated with higher all-cause mortality in the crude analysis (HR 1.56, 95% CI 1.06–2.54), but not in the adjusted analysis (HR 1.45, 95% CI 0.79–2.45). Severe periodontitis was even more strongly associated with higher cirrhosis-related mortality (crude HR 2.19, 95% CI 1.07–4.50 and adjusted HR 2.29, 95% CI 1.04–4.99). No association was found between edentulism and mortality.ConclusionThe presence of severe periodontitis predicted a more than double one-year cirrhosis mortality. These findings may motivate intervention trials on the effect of periodontitis treatment in patients with cirrhosis.

KW - All-cause mortality

KW - cirrhosis

KW - mortality

KW - oral health

KW - periodontitis

U2 - 10.1177/2050640617715846

DO - 10.1177/2050640617715846

M3 - Journal article

C2 - 29435316

VL - 6

SP - 73

EP - 80

JO - United European Gastroenterology Journal

JF - United European Gastroenterology Journal

SN - 2050-6406

IS - 1

ER -