Table 3.
Proportional Hazards Modeling OH variables for all pneumonia*
| A. Without Adjustment for prior pneumonia or smoking history | ||||
| Variable | Hazard Ratio | Lower limit | Upper limit | p-value |
| A.A. # of missing teeth | ||||
| Best vs Worst | 0.65 | 0.54 | 0.79 | < 0.001 |
| Moderate vs Worst | 0.77 | 0.64 | 0.92 | 0.005 |
| 3-group p-value | < 0.001 | |||
| A.B. % of teeth with PPD ≥ 5 mm | ||||
| Best vs Worst | 0.93 | 0.80 | 1.08 | 0.335 |
| Moderate vs Worst | 0.79 | 0.68 | 0.93 | 0.005 |
| 3-group p-value | 0.017 | |||
| A.C. Clinical Periodontal Status | ||||
| Best vs Worst | 0.72 | 0.58 | 0.90 | 0.004 |
| Moderate vs Worst | 0.77 | 0.61 | 0.95 | 0.017 |
| 3-group p-value | 0.008 | |||
| A.D. % of teeth with restorations | ||||
| Best vs Worst | 1.21 | 1.01 | 1.44 | 0.038 |
| Moderate vs Worst | 1.04 | 0.87 | 1.25 | 0.652 |
| 3-group p-value | 0.087 | |||
| A.E. % of teeth with BOP | ||||
| Best vs Worst | 0.89 | 0.77 | 1.04 | 0.152 |
| Moderate vs Worst | 0.96 | 0.82 | 1.11 | 0.551 |
| 3-group p-value | 0.355 | |||
| B. With Adjustment for pneumonia history and smoking history | ||||
| Variable | Hazard Ratio | (lower limit) | (upper limit) | p-value |
| B.A # of missing teeth | ||||
| Best vs Worst | 0.74 | 0.61 | 0.91 | 0.003 |
| Moderate vs Worst | 0.83 | 0.68 | 0.99 | 0.043 |
| 3-group p-value | 0.010 | |||
| B.B % of teeth with PPD ≥ 5 mm | ||||
| Best vs Worst | 0.96 | 0.82 | 1.12 | 0.575 |
| Moderate vs Worst | 0.82 | 0.70 | 0.96 | 0.013 |
| 3-group p-value | 0.038 | |||
| B.C. Clinical Periodontal Status | ||||
| Best vs Worst | 0.78 | 0.62 | 0.97 | 0.029 |
| Moderate vs Worst | 0.82 | 0.66 | 1.02 | 0.074 |
| 3-group p-value | 0.061 | |||
| B.D. % of teeth with restorations | ||||
| Best vs Worst | 1.25 | 1.05 | 1.49 | 0.013 |
| Moderate vs Worst | 1.07 | 0.89 | 1.28 | 0.491 |
| 3-group p-value | 0.034 | |||
| B.E. % of teeth with BOP | ||||
| Best vs Worst | 0.89 | 0.76 | 1.03 | 0.118 |
| Moderate vs Worst | 0.97 | 0.84 | 1.13 | 0.715 |
| 3-group p-value | 0.262 | |||
| Without adjustment for prior pneumonia or smoking history | ||||
| Variable | Hazard Ratio | Lower Limit | Upper Limit | p value |
| C.A # of missing teeth | ||||
| Best vs worst | 0.71 | 0.53 | 0.95 | 0.021 |
| Moderate vs worst | 0.61 | 0.45 | 0.82 | 0.001 |
| 3-group p value | 0.003 | |||
| C.B % of teeth with PPD ≥ 5 mm | ||||
| Best vs worst | 0.91 | 0.72 | 1.16 | 0.464 |
| Moderate vs worst | 0.85 | 0.67 | 1.08 | 0.189 |
| 3-group p value | 0.418 | |||
| C.C. Clinical Periodontal Status | ||||
| Best vs worst | 0.68 | 0.47 | 1.00 | 0.048 |
| Moderate vs worst | 0.76 | 0.53 | 1.09 | 0.137 |
| 3-group p value | 0.109 | |||
| C.D. % of teeth with restorations | ||||
| Best vs worst | 1.10 | 0.83 | 1.46 | 0.506 |
| Moderate vs worst | 0.99 | 0.74 | 1.32 | 0.921 |
| 3-group p value | 0.702 | |||
| C.E. % of teeth with BOP | ||||
| Best vs worst | 0.74 | 0.58 | 0.93 | 0.011 |
| Moderate vs worst | 0.93 | 0.75 | 1.16 | 0.532 |
| 3-group p value | 0.033 | |||
| D. With adjustment for prior pneumonia and smoking history | ||||
| Variable | Hazard Ratio | Upper Limit | Lower limit | p value |
| 3D.A # of missing teeth | ||||
| Best vs Worst | 0.81 | 0.60 | 1.10 | 0.177 |
| Moderate vs Worst | 0.65 | 0.48 | 0.89 | 0.007 |
| 3-group p value | 0.025 | |||
| D.B % of teeth with PPD ≥ 5 mm | ||||
| Best vs Worst | 0.96 | 0.76 | 1.22 | 0.730 |
| Moderate vs Worst | 0.88 | 0.69 | 1.13 | 0.317 |
| 3-group p value | 0.600 | |||
| D.C. Clinical Periodontal Status | ||||
| Best vs Worst | 0.72 | 0.49 | 1.06 | 0.097 |
| Moderate vs Worst | 0.80 | 0.55 | 1.15 | 0.225 |
| 3-group p value | 0.217 | |||
| D.D. % of teeth with restorations | ||||
| Best vs Worst | 1.15 | 0.86 | 1.52 | 0.346 |
| Moderate vs Worst | 1.02 | 0.76 | 1.36 | 0.889 |
| 3-group p value | 0.592 | |||
| D.E. % of teeth with BOP | ||||
| Best vs Worst | 0.74 | 0.59 | 0.94 | 0.012 |
| Moderate vs Worst | 0.96 | 0.78 | 1.19 | 0.701 |
| 3-group p value | 0.031 | |||
Tables 3 summarizes key study outcomes derived by proportional hazards modeling of OH variables with potential for impacting on pneumonia risk for the following OH variables:
A. Number of missing teeth (MT);
B. Percent of teeth with periodontal pocket depth (PPD) ≥ 5 mm
C. AAP periodontal score (11) assigned during dental clinical assessment of periodontal parameters, where scores ≥ III, IV, V indicates PD of increasing severity, respectively;
D. Percent of evaluable teeth with restorations
E. Percent of teeth with bleeding on probing (BOP)
The following outcomes are summarized in Table 3:
(3A) Proportional hazard (PH) modeling outcomes of OH variables (A-E) relative to any incident pneumonia,
(3A.A-E): unadjusted for prior pneumonia;
(3B.A-E): adjusted for prior pneumonia and smoking history
(3C.A-E): PH modeling outcomes of OH variables for CAP subtype, unadjusted for prior pneumonia;
(3D.A-E): PH modeling outcomes of OH variables for CAP subtype adjusted for prior pneumonia and smoking history
PH modeling compared subgroups stratified based on good, intermediate and poor OHS groups for OH variables that contributed significantly to risk for any pneumonia examining both unadjusted data and data adjusted for prior pneumonia and smoking status. Significant p values for OH variables contributing to any pneumonia risk for unadjusted models included: a) number of missing teeth and b) clinical periodontal status. Following adjustment for prior pneumonia and smoking status, only number of missing teeth retained a significant p value
PH modeling of CAP pneumonia comparing groups stratified by good, intermediate and poor OHS identified ‘number of missing teeth’ as the OH variable that exhibited significant p values for CAP risk for both the unadjusted model, and model adjusted for prior pneumonia and smoking