Impact of occlusal support on postoperative complications in patients with colorectal cancer resections

Although poor oral health has been associated with longer hospital stays and higher medical costs, no studies have specifically examined the relationship between preoperative dental status and postoperative complications in patients undergoing gastrointestinal cancer surgery. The objective of this study was to evaluate the occlusal support range in patients aged 65 years and older in relation to inpatient dietary habits and postoperative outcomes, and to determine whether decreased occlusal support is a factor influencing postoperative infectious complications.

In total, 169 patients, aged 65 years or older and undergoing colorectal cancer resection, were included. Preoperatively, dentists assessed occlusal support using the Eichner index (EI). Based on the EI classification, dietitians, a speech-language-hearing therapist, and nurses collaboratively selected an appropriate diet for each patient. The impact of a lower EI on postoperative outcomes and infectious complications was then evaluated.

Patients were categorized into three groups according to their EI: Group A (n=57), Group B (n=55), and Group C (n=57). Following hospitalization, the proportion of Group C patients consuming porridge as their staple food increased, while no significant difference was observed between Groups A and B. However, the percentage of patients consuming chopped side dishes increased across all groups. Regarding postoperative outcomes, although there were no differences in EI, nutritional sufficiency ratio (%), and protein intake (g/kg) among the groups, these variables were associated with the dates of diet initiation and IV infusion completion, duration after IV infusion completion, postoperative hospital stay length, and postoperative weight loss rate. Univariate analysis revealed that EI (A/C), EI (B/C), modified Glasgow prognostic score (score 2), prognostic nutritional index (≤40), low psoas muscle index, stage (IV), lymph node metastasis (≥ N1), blood loss, colostomy, and significantly influenced the incidence of postoperative infectious complications (P<0.05). Multivariate analysis revealed that EI (A/C), EI (B/C), modified Glasgow prognostic score (score 2), and blood loss were independent predictors of postoperative infectious complications (P<0.05).

Although postoperative nutritional intake was comparable between patients with reduced and adequate occlusal support, those with reduced preoperative occlusal support had worse outcomes. These findings suggest that the EI may be a useful predictor of postoperative infectious complications.