The impact of oral diseases in cirrhosis on complications and mortality

Lea Ladegaard Grønkjær*, Palle Holmstrup, Peter Jepsen, Hendrik Vilstrup

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Abstrakt

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.

OriginalsprogEngelsk
TidsskriftJGH Open
Vol/bind5
Udgave nummer2
Sider (fra-til)294-300
DOI
StatusUdgivet - feb. 2021

Bibliografisk note

Funding Information:
The authors thank dental hygienists Nanna Jensen, Natasja Nielsen, and Susanne Hedegaard for performing clinical oral examinations and Dr Kristoffer Schwartz DDS at the Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark, for performing the radiographic examinations. Lea Ladegaard Grønkjær received grants from Aarhus University Hospital, Aase & Ejnar Danielsens Foundation, A.P. Møller Foundation, Central Denmark Region Foundation for Health Research, and the Novo Nordisk Foundation. None of the other authors received any funds or has any financial interests to disclose.

Publisher Copyright:
© 2021 The Authors. JGH Open: An open access journal of gastroenterology and hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

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