Chai John, Chu Frederick C S, Chow Tak W, Shum Nam C, Hui Wendy W H
Northwestern University, Chicago, Illinois, USA.
Int J Prosthodont. 2006 May-Jun;19(3):244-9.
To investigate 6 dental statuses as risk factors for malnutrition in geriatric patients admitted to a convalescent and rehabilitation hospital.
One hundred twenty (59 men and 61 women) geriatric patients admitted to a convalescent and rehabilitation hospital were recruited. Three biochemical and hematologic parameters (albumin, hemoglobin, and lymphocyte count) were used for analysis. Malnutrition was defined as Body Mass Index (BMI) below 18.5 and albumin level under 35 g/L. The number of natural or prosthetic teeth in the dentate patients, and the presence of one or both dentures in the edentate patients, were recorded. Risk factors associated with malnutrition were investigated, namely: (1) edentulism among all patients, (2) edentulism without a set of complete dentures among all patients, (3) edentulism without a set of complete dentures among the edentate patients, (4) decreased number (< 6) of occluding pairs of natural or prosthetic teeth among the dentate patients, (5) decreased number (< 5) of posterior occluding pairs of natural or prosthetic teeth among the dentate patients, and (6) absence of posterior occluding pairs of natural or prosthetic teeth among the dentate patients. One-way ANOVA and Bonferroni multiple comparisons were used to determine if significant differences in the anthropometric, biochemical, and hematologic parameters existed between the patients with different dental statuses. The odds ratio and significance of 6 dental statuses as risk factors of malnutrition were calculated (P = .05).
BMI, albumin, and hemoglobin levels of the malnourished patients were significantly lower than those of nourished patients (P < .05). Lymphocyte count was not significantly different between the 2 patient groups (P > .05). The status of edentate patients without a set of complete dentures compared with other edentate and dentate patients was the only independent risk factor (P < .05) in the 6 statuses studied.
Primary healthcare workers caring for hospitalized geriatric patients should identify edentate patients without a set of complete dentures for the possibility of malnutrition.
调查6种牙齿状况作为康复疗养医院老年住院患者营养不良的风险因素。
招募了120名（59名男性和61名女性）入住康复疗养医院的老年患者。使用三项生化和血液学参数（白蛋白、血红蛋白和淋巴细胞计数）进行分析。营养不良定义为体重指数（BMI）低于18.5且白蛋白水平低于35g/L。记录有牙患者的天然牙或假牙数量，以及无牙患者是否佩戴一副或两副假牙。研究了与营养不良相关的风险因素，即：（1）所有患者中的无牙状态；（2）所有患者中无一副完整假牙的无牙状态；（3）无牙患者中无一副完整假牙的无牙状态；（4）有牙患者中天然牙或假牙的咬合对数量减少（<6对）；（5）有牙患者中天然牙或假牙的后牙咬合对数量减少（<5对）；（6）有牙患者中无天然牙或假牙的后牙咬合对。采用单因素方差分析和Bonferroni多重比较来确定不同牙齿状况的患者在人体测量、生化和血液学参数上是否存在显著差异。计算6种牙齿状况作为营养不良风险因素的比值比和显著性（P = 0.05）。
营养不良患者的BMI、白蛋白和血红蛋白水平显著低于营养良好的患者（P < 0.05）。两组患者的淋巴细胞计数无显著差异（P > 0.05）。在研究的6种状况中，无一副完整假牙的无牙患者与其他无牙和有牙患者相比，是唯一的独立风险因素（P < 0.05）。
照顾住院老年患者的基层医护人员应识别无一副完整假牙的无牙患者，以判断其是否有营养不良的可能性。
