Association between perioperative oral care and postoperative pneumonia after cancer resection: conventional versus high-dimensional propensity score matching analysis
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Perioperative oral care was reported to decrease postoperative pneumonia after cancer resections. However, the effect remains controversial because previous studies were limited due to their small sample sizes and lack of strict control for patient backgrounds. The present study evaluated the association between perioperative oral care and postoperative pneumonia using high-dimensional propensity score (hd-PS) matching to adjust for confounding factors.
Materials and methods
Using a Japanese health insurance claims database, we identified patients who underwent surgical treatment of cancer from April 2014 to March 2015. To compare outcomes (postoperative pneumonia and procedure-related complications) between patients with and without perioperative oral care, we performed hd-PS matching and conventional PS matching and chi-square test.
We identified 621 patients with oral care and 4374 patients without oral care. The occurrences of postoperative pneumonia were not significantly different between patients with and without oral care in the unmatched (2.9% vs. 3.2%), conventional PS-matched (2.9% vs. 2.9%), or hd-PS-matched (2.9% vs. 3.3%) groups. The occurrences of procedure-related complication were not significantly different between patients with and without oral care in the unmatched (23.8% vs. 24.5%), conventional PS-matched (23.8% vs. 26.4%), or hd-PS-matched (24.4% vs. 27.7%) groups.
There was no significant difference in postoperative pneumonia or procedure-related complications between patients with and without perioperative oral care.
While maintaining optimal oral care in cancer patients is an important goal, the present study revealed no significant difference in postoperative outcomes. Further investigations would be needed to determine the effect of perioperative oral care.
KeywordsOral hygiene Perioperative care Postoperative complications Propensity score analysis
This work was supported by grants from the Ministry of Health, Labour and Welfare, Japan (H29-Policy-Designated-009 and H29-ICT-General-004); Ministry of Education, Culture, Sports, Science, and Technology, Japan (17H04141); and the Japan Agency for Medical Research and Development (AMED).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The Institutional Review Board at The University of Tokyo approved the study protocol.
Informed consent was waived because of the anonymous nature of the data.
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