The effects of perioperative oral management on perioperative serum albumin levels in patients treated surgically under general anesthesia

Abstract

The purpose of the present study was to investigate the efficacy of perioperative oral managements (POMs) on perioperative nutritional conditions in patients undergoing surgery with general anesthesia. Medical records were retrospectively reviewed and the effects of POMs were investigated based on a large number of cases using a multicenter analysis. The profile of serum albumin levels was assessed and compared between patients with and without POMs using the multivariate analysis. Seventeen Eleven thousand and one hundred sixty patients (4,873 males and 6,287 females) were reviewed. Of these, 2710 patients (24.3%) had undergone POMs. The results of a multivariate analysis revealed the significant positive effect of POMs on perioperative serum albumin level (change between at admission and discharge, (Estimate: 0.022, standard error: 0.012, P < .0001). Patient gender, age, surgical site, performance status, the American Society of Anesthesiologists (ASA) physical status classification, operation time, amount of blood loss, and serum albumin level at admission were also significant predictors. Adjusted multivariate analysis of the effects of POMs on perioperative change of serum albumin level in all subjects reveled the significance of POMs intervention (estimate: 0.022, standard error: 0.012, P < .0001). These results suggest that POMs exerts significant positive effects on perioperative serum albumin levels in patients underwent surgery under general anesthesia.

Number of Bacteria in Saliva in the Perioperative Period and Factors Associated with Increased Numbers

“…However, unintentional aspiration of saliva in the lower respiratory tract, especially in cases with compromised immunity, can cause aspiration pneumonia. Soutome and Iwata reported that pre-and postoperative oral management significantly suppressed the incidence of postoperative pneumonia in patients after esophageal and lung cancer surgeries [2,11]. The purpose of this study was to clarify whether the number of bacteria in saliva increases after surgery and the patients in whom such an increase may occur.…”

“…Postoperative complications may occur after invasive surgical procedures such as cancer surgery, cardiac surgery, and organ transplant surgery. Some complications may be caused by pathogenic microorganisms derived from the oral cavity, and to reduce the risk of such complications, a clean oral environment and elimination of the infectious source in the oral cavity are essential [1][2][3][4]. In Japan, oral care before and after surgery has been included in the public medical insurance since 2012 and is commonly performed.…”

Positive Impact of Perioperative Oral Management on the Risk of Surgical Site Infections after Abdominal Surgery: A Analysis of Real-World Data from 16 University Hospitals in Japan

“…In addition, we recently found that POM had signi cant positive effects on perioperative serum albumin levels in patients that were treated surgically under general anesthesia [21]. It has been reported that a decreased serum albumin level is an independent risk factor for severe postoperative complications and a poor prognosis [21]. Some researchers have reported that dental infections and poor oral health are closely related to lower serum albumin levels [21].…”

“…We assessed the changes in the prevalence of oral bacteria detected in blood cultures before and after the introduction of insurance coverage for POM and found that the introduction of insurance coverage for POM had a bene cial effect on the frequency of systemic infections caused by oral bacteria [20]. In addition, we recently found that POM had signi cant positive effects on perioperative serum albumin levels in patients that were treated surgically under general anesthesia [21]. It has been reported that a decreased serum albumin level is an independent risk factor for severe postoperative complications and a poor prognosis [21].…”

“…It has been reported that a decreased serum albumin level is an independent risk factor for severe postoperative complications and a poor prognosis [21]. Some researchers have reported that dental infections and poor oral health are closely related to lower serum albumin levels [21]. POM, including oral care, the removal of chronic dental infections, and prosthodontic treatments, has positive effects on serum albumin levels, which might consequently reduce the risk of SSI after abdominal surgery [21].…”