Association Between Preventive Dental Scaling and Hospital Readmission in Patients Undergoing Cardiac Surgery: A Nationwide Population-Based Cohort Study

초록

Purposes: Periodontal disease triggers systemic inflammatory cascades that adversely affect cardiovascular prognosis. However, large-scale population-based evidence evaluating the impact of preoperative preventive oral care on post-discharge readmission among patients undergoing major cardiovascular surgery or procedures remains scarce. Objectives: This study investigated the association between preoperative preventive dental scaling and the risks of post-discharge all-cause and cardiovascular readmissions. Methodology: A nationwide cohort of adult patients who underwent cardiovascular surgery or procedures in 2024 was constructed using claims data from the Health Insurance Review & Assessment Service (HIRA). Kaplan-Meier analyses were used to estimate readmission incidence and group differences were assessed using the log-rank test. To address baseline imbalances, inverse probability of treatment weighting (IPTW) was applied, while weighted multivariable Cox regression models were used to estimate hazard ratios. Results: A total of 78,431 patients were included, comprising 5,012 individuals in the Dental Scaling Group (DSG) and 73,419 individuals in the Non-Dental Scaling Group (NDSG). After IPTW and multivariable adjustment, the DSG showed a significantly lower risk of all-cause readmission (aHR = 0.962; 95% CI = 0.949–0.975, P<0.001). This association remained significant in the competing-risk analysis (aHR = 0.937; 95% CI, 0.925–0.950; P < 0.001). The DSG also showed a significantly lower risk of cardiovascular readmission (aHR = 0.914; 95% CI, 0.897–0.932; P < 0.001), which persisted after accounting for competing mortality risk (aHR = 0.861; 95% CI, 0.846–0.877; P < 0.001). Consistent associations were observed across most subgroups, with more pronounced effects among patients with chronic kidney disease, chronic obstructive pulmonary disease, and prior myocardial infarction. Conclusion: Preoperative preventive dental scaling was associated with reduced risk of all-cause readmission and cardiovascular readmission after major cardiovascular procedures. These findings provide real-world support for integrating medical-dental collaborative care and for policy efforts that expand coverage for perioperative preventive oral management.

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