Impact of Mandatory Preoperative Dental Screening on Infective Endocarditis in Patients Undergoing Surgical Valve Replacement
Background: Guidelines recommend preoperative dental screening (PDS) prior to surgical valve replacement (SVR) to reduce risk of prosthetic valve infective endocarditis (IE). Nonetheless, limited data support these recommendations. Objectives: The objective of this study was to investigate the impac...
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Elsevier
2025-02-01
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| Series: | JACC: Advances |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772963X24008524 |
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| author | Lytfi Krasniqi, MD Poul Erik Mortensen, MD Emil Johannes Ravn, MD Marlene Tofterup, MD Henrik Nissen, MD, PhD Christian Juhl Terkelsen, MD, PhD, DMSCi Niels Holmark Andersen, MD, PhD, DMSCi Ivy Modrau, MD, DMSCi Kasper Stokbro, DDS, PhD Jonas A. Povlsen, MD, PhD Oke Gerke, MSc, PhD, DMSCi Jesper Hallas, MD, DMSCi Marie-Annick Clavel, DVM, PhD Lars Peter Schødt Riber, MD, PhD, DMSCi Jordi Sanchez Dahl, MD, PhD, DMSCi |
| author_facet | Lytfi Krasniqi, MD Poul Erik Mortensen, MD Emil Johannes Ravn, MD Marlene Tofterup, MD Henrik Nissen, MD, PhD Christian Juhl Terkelsen, MD, PhD, DMSCi Niels Holmark Andersen, MD, PhD, DMSCi Ivy Modrau, MD, DMSCi Kasper Stokbro, DDS, PhD Jonas A. Povlsen, MD, PhD Oke Gerke, MSc, PhD, DMSCi Jesper Hallas, MD, DMSCi Marie-Annick Clavel, DVM, PhD Lars Peter Schødt Riber, MD, PhD, DMSCi Jordi Sanchez Dahl, MD, PhD, DMSCi |
| author_sort | Lytfi Krasniqi, MD |
| collection | DOAJ |
| description | Background: Guidelines recommend preoperative dental screening (PDS) prior to surgical valve replacement (SVR) to reduce risk of prosthetic valve infective endocarditis (IE). Nonetheless, limited data support these recommendations. Objectives: The objective of this study was to investigate the impact of mandatory preoperative dental screening (MPDS) on risk of IE in patients undergoing SVR. Methods: Patients undergoing SVR in Western Denmark from 2020 to 2022 were included in this observational study. Patients were considered based on 2 applied PDS practices: MPDS, and no routine referral to preoperative dental screening (NPDS). Data were retrieved from Danish registries and adjudicated using medical records. The primary endpoint was incidence of IE. Secondary endpoints were all-cause mortality, and the composite endpoint of IE and all-cause mortality. Results: A total of 1,207 patients undergoing SVR were included. Of 805 patients in the MPDS, 93% (n = 751) underwent subsequent PDS, compared to 5% (n = 21) among 402 patients in the NPDS. Patients in the MPDS were older with higher rates of coexisting comorbidities. During a median follow-up of 2.6 years, 3.3% (n = 40) developed IE. The IE incidence rate for MPDS and NPDS was 16.0 (95% CI: 11.3-22.6) and 8.0 (95% CI: 4.0-16.0) per 1,000 person-years, respectively. Mortality rate was higher in MPDS (2-year mortality: 6.2% (95% CI: 4.7-8.1) vs 2.8% (95% CI: 1.6-5.0). Differences in IE rates, all-cause mortality but not composite endpoint were abolished in 370 propensity score-matched patients. Conclusions: Risk of IE was low regardless of PDS practice. MPDS prior to surgery did not alter the risk of IE or all-cause mortality in patients undergoing SVR in Denmark. |
| format | Article |
| id | doaj-art-86071d40ba6949c09d2aa179baa880af |
| institution | Kabale University |
| issn | 2772-963X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JACC: Advances |
| spelling | doaj-art-86071d40ba6949c09d2aa179baa880af2025-01-18T05:05:38ZengElsevierJACC: Advances2772-963X2025-02-0142101571Impact of Mandatory Preoperative Dental Screening on Infective Endocarditis in Patients Undergoing Surgical Valve ReplacementLytfi Krasniqi, MD0Poul Erik Mortensen, MD1Emil Johannes Ravn, MD2Marlene Tofterup, MD3Henrik Nissen, MD, PhD4Christian Juhl Terkelsen, MD, PhD, DMSCi5Niels Holmark Andersen, MD, PhD, DMSCi6Ivy Modrau, MD, DMSCi7Kasper Stokbro, DDS, PhD8Jonas A. Povlsen, MD, PhD9Oke Gerke, MSc, PhD, DMSCi10Jesper Hallas, MD, DMSCi11Marie-Annick Clavel, DVM, PhD12Lars Peter Schødt Riber, MD, PhD, DMSCi13Jordi Sanchez Dahl, MD, PhD, DMSCi14Department of Cardiothoracic Surgery, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Address for correspondence: Dr Lytfi Krasniqi, Odense University Hospital J. B. Winsløwsvej 4, 5000 Odense C, Denmark.Department of Cardiothoracic Surgery, Odense University Hospital, Odense, DenmarkDepartment of Cardiothoracic Surgery, Odense University Hospital, Odense, DenmarkDepartment of Cardiology, Odense University Hospital, Odense, DenmarkDepartment of Cardiology, Odense University Hospital, Odense, DenmarkDepartment of Cardiology, Aarhus University Hospital, Aarhus, DenmarkDepartment of Cardiology, Aalborg University Hospital, Aalborg, DenmarkDepartment of Cardiac, Thoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, DenmarkDepartment of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Oral and Maxillofacial Surgery, Odense University Hospital, Odense, DenmarkDepartment of Cardiology, Aarhus University Hospital, Aarhus, DenmarkDepartment of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Nuclear Medicine, Odense University Hospital, Odense, DenmarkDepartment of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, Odense, DenmarkDepartment of Cardiology, Odense University Hospital, Odense, DenmarkDepartment of Cardiothoracic Surgery, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, DenmarkDepartment of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Cardiology, Odense University Hospital, Odense, DenmarkBackground: Guidelines recommend preoperative dental screening (PDS) prior to surgical valve replacement (SVR) to reduce risk of prosthetic valve infective endocarditis (IE). Nonetheless, limited data support these recommendations. Objectives: The objective of this study was to investigate the impact of mandatory preoperative dental screening (MPDS) on risk of IE in patients undergoing SVR. Methods: Patients undergoing SVR in Western Denmark from 2020 to 2022 were included in this observational study. Patients were considered based on 2 applied PDS practices: MPDS, and no routine referral to preoperative dental screening (NPDS). Data were retrieved from Danish registries and adjudicated using medical records. The primary endpoint was incidence of IE. Secondary endpoints were all-cause mortality, and the composite endpoint of IE and all-cause mortality. Results: A total of 1,207 patients undergoing SVR were included. Of 805 patients in the MPDS, 93% (n = 751) underwent subsequent PDS, compared to 5% (n = 21) among 402 patients in the NPDS. Patients in the MPDS were older with higher rates of coexisting comorbidities. During a median follow-up of 2.6 years, 3.3% (n = 40) developed IE. The IE incidence rate for MPDS and NPDS was 16.0 (95% CI: 11.3-22.6) and 8.0 (95% CI: 4.0-16.0) per 1,000 person-years, respectively. Mortality rate was higher in MPDS (2-year mortality: 6.2% (95% CI: 4.7-8.1) vs 2.8% (95% CI: 1.6-5.0). Differences in IE rates, all-cause mortality but not composite endpoint were abolished in 370 propensity score-matched patients. Conclusions: Risk of IE was low regardless of PDS practice. MPDS prior to surgery did not alter the risk of IE or all-cause mortality in patients undergoing SVR in Denmark.http://www.sciencedirect.com/science/article/pii/S2772963X24008524infectious endocarditispreoperative dental screeningvalve replacement |
| spellingShingle | Lytfi Krasniqi, MD Poul Erik Mortensen, MD Emil Johannes Ravn, MD Marlene Tofterup, MD Henrik Nissen, MD, PhD Christian Juhl Terkelsen, MD, PhD, DMSCi Niels Holmark Andersen, MD, PhD, DMSCi Ivy Modrau, MD, DMSCi Kasper Stokbro, DDS, PhD Jonas A. Povlsen, MD, PhD Oke Gerke, MSc, PhD, DMSCi Jesper Hallas, MD, DMSCi Marie-Annick Clavel, DVM, PhD Lars Peter Schødt Riber, MD, PhD, DMSCi Jordi Sanchez Dahl, MD, PhD, DMSCi Impact of Mandatory Preoperative Dental Screening on Infective Endocarditis in Patients Undergoing Surgical Valve Replacement JACC: Advances infectious endocarditis preoperative dental screening valve replacement |
| title | Impact of Mandatory Preoperative Dental Screening on Infective Endocarditis in Patients Undergoing Surgical Valve Replacement |
| title_full | Impact of Mandatory Preoperative Dental Screening on Infective Endocarditis in Patients Undergoing Surgical Valve Replacement |
| title_fullStr | Impact of Mandatory Preoperative Dental Screening on Infective Endocarditis in Patients Undergoing Surgical Valve Replacement |
| title_full_unstemmed | Impact of Mandatory Preoperative Dental Screening on Infective Endocarditis in Patients Undergoing Surgical Valve Replacement |
| title_short | Impact of Mandatory Preoperative Dental Screening on Infective Endocarditis in Patients Undergoing Surgical Valve Replacement |
| title_sort | impact of mandatory preoperative dental screening on infective endocarditis in patients undergoing surgical valve replacement |
| topic | infectious endocarditis preoperative dental screening valve replacement |
| url | http://www.sciencedirect.com/science/article/pii/S2772963X24008524 |
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