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. 2024 Nov 23;32(12):816.
doi: 10.1007/s00520-024-08991-5.

Oral foci of infection and their relationship with hospital stay after haematopoietic cell transplantation

Lucky L A van Gennip  1 , Renske Z Thomas  2 , Marjolein S Bulthuis  2 , Gerjon Hannink  3 , Ewald M Bronkhorst  2 , Nicole M A Blijlevens #  4 , Stephanie J M van Leeuwen #  2 , Marie-Charlotte D N J M Huysmans  2
Affiliations

Oral foci of infection and their relationship with hospital stay after haematopoietic cell transplantation

Lucky L A van Gennip et al. Support Care Cancer. .

Erratum in

Abstract

Purpose: Oral focus screening is recommended before HCT (haematopoietic cell transplantation). Acute foci are generally treated pre-HCT. However, it is unclear whether chronic foci should be treated pre-HCT. This study aimed to evaluate the association between number of foci and early post-HCT morbidity and mortality.

Methods: Patients who received an oral screening pre-HCT at Radboudumc between 2013 and 2023, with a recent panoramic radiograph, were included. Foci were defined as teeth or implants with deep pockets, furcation radiolucencies, periapical radiolucencies, deep caries, partial eruption or retained roots. Dental interventions were provided pre-HCT if deemed necessary and possible. Hospital length of stay (LOS), mortality and oral exacerbations were assessed in the first hundred days post-HCT. Hospital LOS was log-transformed to normalize its skewed distribution. Multivariate regression analyses were performed.

Results: Five hundred patients were included (median age 58 years, 37% female, 56% allogeneic). Four acute foci in two patients remained untreated pre-HCT. Forty-eight percent had at least one untreated chronic focus pre-HCT (mostly furcation radiolucencies and post-endodontic periapical lesions). Mean LOS was 22 days; 20 patients died, and four patients had an oral exacerbation before HCT day + 100. After adjustment for conditioning intensity, age, socioeconomic status and number of teeth, HCT recipients with ≥ 3 foci had five additional days in the hospital compared to those without foci (ratio of means 1.21; 95% CI 1.00 - 1.46). The number of foci was not associated with early post-HCT mortality.

Conclusion: The presence of ≥ 3 oral foci is associated with extended hospital LOS in the first hundred days post-HCT.

Keywords: Dental caries; Dentition; Haematologic diseases; Observational study; Periapical diseases; Periodontal diseases; Stem cell transplantation.

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Conflict of interest statement

Declarations. Ethics approval: Ethical approval was waived by the ethical committee of the Radboudumc because this research was not subjected to the law governing research involving human subjects. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Association between the number of oral foci after pre-HCT dental treatment (reference category is no oral focus) and both hospital length of stay and mortality in the first hundred days after transplant. Models were adjusted for conditioning intensity, age, socioeconomic status and number of teeth for the outcome hospital length of stay and for conditioning intensity for the outcome mortality
Fig. 2
Fig. 2
Association between number of oral foci after pre-HCT dental treatment (reference category is no oral focus) and hospital length of stay in the first hundred days after transplant for autologous and allogeneic HCT recipients. Models were adjusted for age, socioeconomic status and number of teeth for autologous HCT recipients and for conditioning intensity, age, socioeconomic status and number of teeth for allogeneic HCT recipients
See this image and copyright information in PMC

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