原创力文档a retrospective investigation of advanced periodontal disease as a risk factor for septicemia in hematopoietic stem cell and bone marrow transplant recipients：回顾性调查先进的牙周病是造血干细胞和骨髓移植术后败血症的危险因素.pdfVIP
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a retrospective investigation of advanced periodontal disease as a risk factor for septicemia in hematopoietic stem cell and bone marrow transplant recipients：回顾性调查先进的牙周病是造血干细胞和骨髓移植术后败血症的危险因素
A retrospective investigation of advanced periodontal disease as
a risk factor for septicemia in hematopoietic stem cell and
bone marrow transplant recipients
Sunday O. Akintoye, BDS, DDS, MS,a Michael T. Brennan, DDS, MHS,b
Christopher J. Graber, MD,c Beth E. McKinney, RDH MS,d Thomas E. Rams, DDS, MHS,e
Austin J. Barrett, MD,f and Jane C. Atkinson, DDS,g Bethesda, Md; Charlotte, NC; Seattle,
Wash; Philadelphia, Pa; and Baltimore, Md
NATIONAL INSTITUTES OF HEALTH, CAROLINAS MEDICAL CENTER, UNIVERSITY OF WASHINGTON, TEMPLE
UNIVERSITY SCHOOL OF DENTISTRY, AND UNIVERSITY OF MARYLAND
Objective. Septicemia is a cause of death in hematopoietic stem cell transplant (HSCT) recipients. Extraction of teeth
with advanced periodontitis has been advocated before HSCT to prevent septicemia in myeloablated hosts. The
primary aim of the present study was to determine impact of chronic periodontitis, as measured by radiographic
alveolar bone loss, on septicemia and transplant mortality.
Study design. A retrospective design was used to study 77 subjects who received pretransplant dental evaluation,
panoramic radiography, and full myeloablative allogeneic HSCT to treat hematologic malignancies. Radiographic
crestal alveolar bone loss was measured with a Schei ruler on all teeth. Microorganisms isolated from positive blood
cultures within the first 100 days after transplant were categorized as of likely origin from periodontal, oral, or any
body sites. Spearman correlation and logistic regression analysis assessed associations between positive blood cultures,
mean subject whole-mouth percent radiographic crestal alveolar bone loss, and 100-day survival.
Results. Radiographic crestal alveolar bone loss per study subject averaged 13% 7%, with 18.2% exhibiting bone
loss of 20% or greater. During the initial 100 days after transplant, 63.6% subjects yielded se
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