Abstract: PURPOSE: To investigate the association between oral health abnormality phenotypes based on previous oral health records and heart failure(HF)-related events during follow-up in patients with type 2 diabetes mellitus (T2DM), and to explore their implications for nursing assessment. METHODS: A single-center retrospective cohort study was conducted involving 120 patients with T2DM. According to baseline oral examination records, including periodontal pocket probing depth, gingival bleeding, oral hygiene index (OHI), plaque index (PLI), and tooth loss, the patients were classified into three groups: no obvious periodontal abnormality, mild periodontal pocket deepening, and marked periodontal pocket deepening. General clinical data, oral health indicators, inflammatory markers, lipid profiles, and renal function indicators were collected. Correlation analysis, Kaplan-Meier analysis, and Cox proportional hazards regression models were used to evaluate the relationship between oral health abnormality phenotypes and HF-related events. RESULTS: During follow-up, a total of 46 patients developed HF-related events, with an incidence rate of 38.33%. Kaplan-Meier analysis showed a statistically significant difference in HF event-free survival among the three groups(P=0.019). Oral health indicators were positively correlated with inflammatory markers and negatively correlated with estimated glomerular filtration rate (eGFR) (P<0.05). Cox regression analysis showed that oral health abnormality phenotype stratification was associated with HF-related events in the unadjusted model and the age-adjusted model. However, after further adjustment for eGFR, this association was markedly attenuated, and the model estimates became unstable. Sensitivity analysis showed that no stable association was observed between oral health abnormality phenotype stratification and HF-related events in the subgroup with eGFR ≥60 mL/(min·1.73 m²). CONCLUSIONS: Oral health abnormality phenotypes based on previous oral health records showes a potential association with HF-related events in patients with T2DM, but this relationship is substantially influenced by renal function status. Oral health abnormalities may more likely reflect an overall adverse clinical condition characterized by renal impairment, increased inflammatory burden, and metabolic disturbance. Therefore, oral health status may serve as a useful clue for comprehensive nursing assessment in chronic disease management. However, the current evidence is insufficient to support it as a stable independent predictor of HF-related events.

Key words: Type 2 diabetes mellitus, Heart failure-related events, Periodontal health abnormality, Nursing assessment