Oral Management Improves Patient Outcomes in Hematopoietic Stem Cell Transplantation
Introduction and aims: Oral bacteria influence bloodstream infections in hematopoietic stem cell transplantation (HSCT). We investigated the effects of oral health management and its relationship with medical care delivery systems. Methods: Patients aged >16 years who underwent HSCT, discharged f...
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Elsevier
2025-08-01
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| Series: | International Dental Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S002065392500111X |
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| author | Mutsuko Moriwaki Mikayo Toba Makiko Takizawa Hiroaki Shimizu Haruna Tanaka Chihiro Takahashi Shinobu Imai Masayuki Kakehashi Kiyohide Fushimi |
| author_facet | Mutsuko Moriwaki Mikayo Toba Makiko Takizawa Hiroaki Shimizu Haruna Tanaka Chihiro Takahashi Shinobu Imai Masayuki Kakehashi Kiyohide Fushimi |
| author_sort | Mutsuko Moriwaki |
| collection | DOAJ |
| description | Introduction and aims: Oral bacteria influence bloodstream infections in hematopoietic stem cell transplantation (HSCT). We investigated the effects of oral health management and its relationship with medical care delivery systems. Methods: Patients aged >16 years who underwent HSCT, discharged from Japanese acute care hospitals between April 2018 and March 2022, were categorized into autologous and allogeneic HSCT groups. Multivariable analysis assessed the impact of peri-HSCT oral management on antibiotic use, narcotic injections, and mortality rates. Results: We included 12,248 patients, 5936 autologous and 6312 allogeneic HSCT patients, across 298 hospitals. The defined daily dose (DDD) of antibiotic use within 14 days post-transplantation in the oral and nonoral management groups for allogeneic HSCT patients was 34.10 (standard deviation [SD] 20.35) vs 36.37 (SD 21.33); broad-spectrum antibiotics use was 23.87 (SD 15.82) vs 24.45 (SD 15.76). Within 30 days post-transplantation, the DDD of antibiotic use was 69.13 (SD 40.18) vs 75.16 (SD 43.47) was 45.70 (SD 29.63) vs 47.95 (SD 30.48), respectively. In allogeneic HSCT patients, oral management resulted in lower DDD of antibiotic use by 2.66 within 14 days and 6.74 within 30 days post-transplantation, after adjustment for relevant factors. Broad-spectrum antibiotic use within 30 days post-transplantation showed a lower DDD by 2.79 (P < .01). Narcotic use led to a 0.34 lower DDD (P < .01) within 14 days and 0.70 lower DDD (P < .01) within 30 days. In autologous HSCT patients, oral management did not affect the outcomes. The certification standard for unrelated HSCT, categorized into four classes (no certification and certification levels 1-3), was associated with an 8.41 point increase in hospital oral management implementation per class. Conclusion: Ensuring an appropriate oral environment for allogeneic HSCT patients helps preventing infection, extending life expectancy, and alleviating pain. Clinical relevance: Coordinated care between dental and medical teams is essential to deliver safe, personalized, and high-quality patient outcomes during HSCT. |
| format | Article |
| id | doaj-art-e4bbe789a65c4e19b29203b3eaf3af42 |
| institution | Kabale University |
| issn | 0020-6539 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Dental Journal |
| spelling | doaj-art-e4bbe789a65c4e19b29203b3eaf3af422025-08-20T03:27:24ZengElsevierInternational Dental Journal0020-65392025-08-0175410082210.1016/j.identj.2025.04.003Oral Management Improves Patient Outcomes in Hematopoietic Stem Cell TransplantationMutsuko Moriwaki0Mikayo Toba1Makiko Takizawa2Hiroaki Shimizu3Haruna Tanaka4Chihiro Takahashi5Shinobu Imai6Masayuki Kakehashi7Kiyohide Fushimi8Quality Management Center, Institute of Science Tokyo, Bunkyo-ku, Tokyo, JapanQuality Management Center, Institute of Science Tokyo, Bunkyo-ku, Tokyo, Japan; Corresponding author. Quality Management Center, Institute of Science Tokyo Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.Saitama Medical University General Medical Center, Kawagoe, Saitama, JapanTokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, JapanDepartment of Nursing, Institute of Science Tokyo Hospital, Bunkyo-ku, Tokyo, JapanQuality Management Center, Institute of Science Tokyo, Bunkyo-ku, Tokyo, JapanDepartment of Pharmacoepidemiology, Showa University Graduate School of Pharmacy, Shinagawa, Tokyo, JapanGraduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima City, Hiroshima, JapanQuality Management Center, Institute of Science Tokyo, Bunkyo-ku, Tokyo, Japan; Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Bunkyo-ku, Tokyo, JapanIntroduction and aims: Oral bacteria influence bloodstream infections in hematopoietic stem cell transplantation (HSCT). We investigated the effects of oral health management and its relationship with medical care delivery systems. Methods: Patients aged >16 years who underwent HSCT, discharged from Japanese acute care hospitals between April 2018 and March 2022, were categorized into autologous and allogeneic HSCT groups. Multivariable analysis assessed the impact of peri-HSCT oral management on antibiotic use, narcotic injections, and mortality rates. Results: We included 12,248 patients, 5936 autologous and 6312 allogeneic HSCT patients, across 298 hospitals. The defined daily dose (DDD) of antibiotic use within 14 days post-transplantation in the oral and nonoral management groups for allogeneic HSCT patients was 34.10 (standard deviation [SD] 20.35) vs 36.37 (SD 21.33); broad-spectrum antibiotics use was 23.87 (SD 15.82) vs 24.45 (SD 15.76). Within 30 days post-transplantation, the DDD of antibiotic use was 69.13 (SD 40.18) vs 75.16 (SD 43.47) was 45.70 (SD 29.63) vs 47.95 (SD 30.48), respectively. In allogeneic HSCT patients, oral management resulted in lower DDD of antibiotic use by 2.66 within 14 days and 6.74 within 30 days post-transplantation, after adjustment for relevant factors. Broad-spectrum antibiotic use within 30 days post-transplantation showed a lower DDD by 2.79 (P < .01). Narcotic use led to a 0.34 lower DDD (P < .01) within 14 days and 0.70 lower DDD (P < .01) within 30 days. In autologous HSCT patients, oral management did not affect the outcomes. The certification standard for unrelated HSCT, categorized into four classes (no certification and certification levels 1-3), was associated with an 8.41 point increase in hospital oral management implementation per class. Conclusion: Ensuring an appropriate oral environment for allogeneic HSCT patients helps preventing infection, extending life expectancy, and alleviating pain. Clinical relevance: Coordinated care between dental and medical teams is essential to deliver safe, personalized, and high-quality patient outcomes during HSCT.http://www.sciencedirect.com/science/article/pii/S002065392500111XHematopoietic stem cell transplantationOral managementAntibioticNarcoticIn-hospital mortalityDental hygiene |
| spellingShingle | Mutsuko Moriwaki Mikayo Toba Makiko Takizawa Hiroaki Shimizu Haruna Tanaka Chihiro Takahashi Shinobu Imai Masayuki Kakehashi Kiyohide Fushimi Oral Management Improves Patient Outcomes in Hematopoietic Stem Cell Transplantation International Dental Journal Hematopoietic stem cell transplantation Oral management Antibiotic Narcotic In-hospital mortality Dental hygiene |
| title | Oral Management Improves Patient Outcomes in Hematopoietic Stem Cell Transplantation |
| title_full | Oral Management Improves Patient Outcomes in Hematopoietic Stem Cell Transplantation |
| title_fullStr | Oral Management Improves Patient Outcomes in Hematopoietic Stem Cell Transplantation |
| title_full_unstemmed | Oral Management Improves Patient Outcomes in Hematopoietic Stem Cell Transplantation |
| title_short | Oral Management Improves Patient Outcomes in Hematopoietic Stem Cell Transplantation |
| title_sort | oral management improves patient outcomes in hematopoietic stem cell transplantation |
| topic | Hematopoietic stem cell transplantation Oral management Antibiotic Narcotic In-hospital mortality Dental hygiene |
| url | http://www.sciencedirect.com/science/article/pii/S002065392500111X |
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