Journal of Periodontal and Implant Science

Korean Academy of Periodontology (대한치주과학회)
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Charlson comorbidity index as a predictor of periodontal disease in elderly participants

  • Lee, Jae-Hong (Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry) ;
  • Choi, Jung-Kyu (Department of Health Insurance Research, Ilsan Hospital, National Health Insurance Service) ;
  • Jeong, Seong-Nyum (Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry) ;
  • Choi, Seong-Ho (Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry)
  • Received : 2018.03.03
  • Accepted : 2018.04.22
  • Published : 2018.04.30
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Abstract

Purpose: This study investigated the validity of the Charlson comorbidity index (CCI) as a predictor of periodontal disease (PD) over a 12-year period. Methods: Nationwide representative samples of 149,785 adults aged ${\geq}60$ years with PD (International Classification of Disease, 10th revision [ICD-10], K052-K056) were derived from the National Health Insurance Service-Elderly Cohort during 2002-2013. The degree of comorbidity was measured using the CCI (grade 0-6), including 17 diseases weighted on the basis of their association with mortality, and data were analyzed using multivariate Cox proportional-hazards regression in order to investigate the associations of comorbid diseases (CDs) with PD. Results: The multivariate Cox regression analysis with adjustment for sociodemographic factors (sex, age, household income, insurance status, residence area, and health status) and CDs (acute myocardial infarction, congestive heart failure, peripheral vascular disease, cerebral vascular accident, dementia, pulmonary disease, connective tissue disorders, peptic ulcer, liver disease, diabetes, diabetes complications, paraplegia, renal disease, cancer, metastatic cancer, severe liver disease, and human immunodeficiency virus [HIV]) showed that the CCI in elderly comorbid participants was significantly and positively correlated with the presence of PD (grade 1: hazard ratio [HR], 1.11; P<0.001; grade ${\geq}2$: HR, 1.12, P<0.001). Conclusions: We demonstrated that a higher CCI was a significant predictor of greater risk for PD in the South Korean elderly population.

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References

  1. Lee JH, Lee JS, Park JY, Choi JK, Kim DW, Kim YT, et al. Association of lifestyle-related comorbidities with periodontitis: a nationwide cohort study in Korea. Medicine (Baltimore) 2015;94:e1567. https://doi.org/10.1097/MD.0000000000001567
  2. Lee JH, Choi JK, Kim SH, Cho KH, Kim YT, Choi SH, et al. Association between periodontal flap surgery for periodontitis and vasculogenic erectile dysfunction in Koreans. J Periodontal Implant Sci 2017;47:96-105. https://doi.org/10.5051/jpis.2017.47.2.96
  3. Lee JH, Oh JY, Youk TM, Jeong SN, Kim YT, Choi SH. Association between periodontal disease and noncommunicable diseases: a 12-year longitudinal health-examinee cohort study in South Korea. Medicine (Baltimore) 2017;96:e7398. https://doi.org/10.1097/MD.0000000000007398
  4. Choi JK, Kim YT, Kweon HI, Park EC, Choi SH, Lee JH. Effect of periodontitis on the development of osteoporosis: results from a nationwide population-based cohort study (2003-2013). BMC Womens Health 2017;17:77. https://doi.org/10.1186/s12905-017-0440-9
  5. Lee JH, Kweon HH, Choi JK, Kim YT, Choi SH. Association between periodontal disease and prostate cancer: results of a 12-year longitudinal cohort study in South Korea. J Cancer 2017;8:2959-65. https://doi.org/10.7150/jca.20532
  6. Seymour GJ. Relationship between periodontal infections and systemic disease - the oral systemic connection. Int J Antimicrob Agents 2007;29:S57-8.
  7. LaMonte MJ, Genco RJ, Hovey KM, Wallace RB, Freudenheim JL, Michaud DS, et al. History of periodontitis diagnosis and edentulism as predictors of cardiovascular disease, stroke, and mortality in postmenopausal women. J Am Heart Assoc 2017;6:e004518. https://doi.org/10.1161/JAHA.116.004518
  8. Sharma P, Dietrich T, Ferro CJ, Cockwell P, Chapple IL. Association between periodontitis and mortality in stages 3-5 chronic kidney disease: NHANES III and linked mortality study. J Clin Periodontol 2016;43:104-13. https://doi.org/10.1111/jcpe.12502
  9. Saremi A, Nelson RG, Tulloch-Reid M, Hanson RL, Sievers ML, Taylor GW, et al. Periodontal disease and mortality in type 2 diabetes. Diabetes Care 2005;28:27-32. https://doi.org/10.2337/diacare.28.1.27
  10. Melfi C, Holleman E, Arthur D, Katz B. Selecting a patient characteristics index for the prediction of medical outcomes using administrative claims data. J Clin Epidemiol 1995;48:917-26. https://doi.org/10.1016/0895-4356(94)00202-2
  11. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987;40:373-83. https://doi.org/10.1016/0021-9681(87)90171-8
  12. Jonsen A, Clarke AE, Joseph L, Belisle P, Bernatsky S, Nived O, et al. Association of the Charlson comorbidity index with mortality in systemic lupus erythematosus. Arthritis Care Res (Hoboken) 2011;63:1233-7. https://doi.org/10.1002/acr.20506
  13. Bar B, Hemphill JC 3rd. Charlson comorbidity index adjustment in intracerebral hemorrhage. Stroke 2011;42:2944-6. https://doi.org/10.1161/STROKEAHA.111.617639
  14. Deyo RA, Cherkin DC, Ciol MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol 1992;45:613-9. https://doi.org/10.1016/0895-4356(92)90133-8
  15. Sundararajan V, Henderson T, Perry C, Muggivan A, Quan H, Ghali WA. New ICD-10 version of the Charlson comorbidity index predicted in-hospital mortality. J Clin Epidemiol 2004;57:1288-94. https://doi.org/10.1016/j.jclinepi.2004.03.012
  16. Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol 1999;4:1-6. https://doi.org/10.1902/annals.1999.4.1.1
  17. 1999 International International Workshop for a Classification of Periodontal Diseases and Conditions. Papers. Oak Brook, Illinois, October 30-November 2, 1999. Ann Periodontol 1999;4:i, 1-112. https://doi.org/10.1902/annals.1999.4.1.1
  18. Baldwin LM, Klabunde CN, Green P, Barlow W, Wright G. In search of the perfect comorbidity measure for use with administrative claims data: does it exist? Med Care 2006;44:745-53. https://doi.org/10.1097/01.mlr.0000223475.70440.07
  19. Shiau HJ, Reynolds MA. Sex differences in destructive periodontal disease: a systematic review. J Periodontol 2010;81:1379-89. https://doi.org/10.1902/jop.2010.100044
  20. Lopez R, Smith PC, Gostemeyer G, Schwendicke F. Ageing, dental caries and periodontal diseases. J Clin Periodontol 2017;44 Suppl 18:S145-52. https://doi.org/10.1111/jcpe.12683
  21. Tonetti MS, Bottenberg P, Conrads G, Eickholz P, Heasman P, Huysmans MC, et al. Dental caries and periodontal diseases in the ageing population: call to action to protect and enhance oral health and wellbeing as an essential component of healthy ageing - consensus report of group 4 of the joint EFP/ORCA workshop on the boundaries between caries and periodontal diseases. J Clin Periodontol 2017;44 Suppl 18:S135-44. https://doi.org/10.1111/jcpe.12681
  22. Lee JH, Lee JS, Choi JK, Kweon HI, Kim YT, Choi SH. National dental policies and socio-demographic factors affecting changes in the incidence of periodontal treatments in Korean: A nationwide populationbased retrospective cohort study from 2002-2013. BMC Oral Health 2016;16:118. https://doi.org/10.1186/s12903-016-0310-0
  23. Lee JH, Oh JY, Choi JK, Kim YT, Park YS, Jeong SN, et al. Trends in the incidence of tooth extraction due to periodontal disease: results of a 12-year longitudinal cohort study in South Korea. J Periodontal Implant Sci 2017;47:264-72. https://doi.org/10.5051/jpis.2017.47.5.264
  24. Freisinger E, Malyar NM, Reinecke H. Peripheral artery disease is associated with high in-hospital mortality particularly in males with acute myocardial infarction in a nationwide real-world setting. Vasa 2016;45:169-74. https://doi.org/10.1024/0301-1526/a000512
  25. Kaye EK, Valencia A, Baba N, Spiro A 3rd, Dietrich T, Garcia RI. Tooth loss and periodontal disease predict poor cognitive function in older men. J Am Geriatr Soc 2010;58:713-8. https://doi.org/10.1111/j.1532-5415.2010.02788.x
  26. Wang YH, Lv ZF, Zhong Y, Liu DS, Chen SP, Xie Y. The internalization of Helicobacter pylori plays a role in the failure of H. pylori eradication. Helicobacter 2017;22:e12324. https://doi.org/10.1111/hel.12324
  27. Malfertheiner P, Chan FK, McColl KE. Peptic ulcer disease. Lancet 2009;374:1449-61. https://doi.org/10.1016/S0140-6736(09)60938-7
  28. Anand PS, Nandakumar K, Shenoy KT. Are dental plaque, poor oral hygiene, and periodontal disease associated with Helicobacter pylori infection? J Periodontol 2006;77:692-8. https://doi.org/10.1902/jop.2006.050163
  29. Zaric S, Bojic B, Jankovic L, Dapcevic B, Popovic B, Cakic C, et al. Periodontal therapy improves gastric Helicobacter pylori eradication. J Dent Res 2009;88:946-50. https://doi.org/10.1177/0022034509344559
  30. Scannapieco FA, Bush RB, Paju S. Associations between periodontal disease and risk for nosocomial bacterial pneumonia and chronic obstructive pulmonary disease. A systematic review. Ann Periodontol 2003;8:54-69. https://doi.org/10.1902/annals.2003.8.1.54
  31. Manger D, Walshaw M, Fitzgerald R, Doughty J, Wanyonyi KL, White S, et al. Evidence summary: the relationship between oral health and pulmonary disease. Br Dent J 2017;222:527-33. https://doi.org/10.1038/sj.bdj.2017.315
  32. Sumi Y, Miura H, Michiwaki Y, Nagaosa S, Nagaya M. Colonization of dental plaque by respiratory pathogens in dependent elderly. Arch Gerontol Geriatr 2007;44:119-24. https://doi.org/10.1016/j.archger.2006.04.004
  33. Larsson J, Itenov TS, Bestle MH. Risk prediction models for mortality in patients with ventilatorassociated pneumonia: A systematic review and meta-analysis. J Crit Care 2017;37:112-8. https://doi.org/10.1016/j.jcrc.2016.09.003
  34. Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet 2012;380:37-43. https://doi.org/10.1016/S0140-6736(12)60240-2
  35. Laor A, Tal S, Guller V, Zbar AP, Mavor E. The Charlson comorbidity index (CCI) as a mortality predictor after surgery in elderly patients. Am Surg 2016;82:22-7.
  36. Gil-Montoya JA, de Mello AL, Barrios R, Gonzalez-Moles MA, Bravo M. Oral health in the elderly patient and its impact on general well-being: a nonsystematic review. Clin Interv Aging 2015;10:461-7.

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