Periodontitis affects neurological deficit in acute stroke

Background and purpose: Periodontitis is an independent risk factor for ischaemic stroke, but its influence on stroke severity has not been investigated yet. We studied the association of advanced periodontitis or edentulousness with neurological deficit on admission and short-term outcome of stroke patients. Methods: The study included 169 patients with ischaemic stroke. The neurological deficit on admission was evaluated using the NIH stroke scale (NIHSS). The outcome at discharge was assessed using the modified Rankin scale (mRS) and the Barthel Index (BI). The clinical attachement level (CAL), the distance between cemento-enamel junction and the probed base of periodontal pocket, was recorded for each tooth at six sites. Advanced periodontitis was defined as CAL >= 6 mm in at least one measured site. Results: Patients with advanced periodontitis or edentulousness were older than those with no or mild periodontitis (71.4 years vs. 60.1; p<0.001), had greater neurological deficit on admission (8.9 vs. 5.7; p=0.01) and worse outcome at hospital discharge measured in the mRS (2.2 vs. 1.4; p=0.009). The presence of advanced periodontitis or edentulousness was independent risk factor for greater NIHSS on admission (p=0.025), after adjusting for age, gender and the studied risk factors. The logistic regression model, however, showed that stroke severity on admission but not advanced periodontitis or edentulousness, affected the outcome of stroke patients. Conclusions: Advanced periodontitis or edentulousness in patients with ischaemic stroke is associated with greater neurological deficit on admission. (C) 2010 Elsevier B.V. All rights reserved.