Unit of Bone Marrow Transplantation, Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Social Dentistry, Universidade de São Paulo, São Paulo, Brazil.
Hematol Oncol. 2014 Mar;32(1):31-9. doi: 10.1002/hon.2050. Epub 2013 Apr 29.
Oral mucositis (OM) is one of the side effects of hematopoietic stem cell transplantation (HSCT), resulting in major morbidity. The aim of this study was to determine the cost-effectiveness of the introduction of a specialized oral care program including laser therapy in the care of patients receiving HSCT with regard to morbidity associated with OM. Clinical information was gathered on 167 patients undergoing HSCT and divided according to the presence (n = 91) or absence (n = 76) of laser therapy and oral care. Cost analysis included daily hospital fees, parenteral nutrition (PN) and prescription of opioids. It was observed that the group without laser therapy (group II) showed a higher frequency of severe degrees of OM (relative risk = 16.8, 95% confidence interval -5.8 to 48.9, p < 0.001), with a significant association between this severity and the use of PN (p = 0.001), prescription of opioids (p < 0.001), pain in the oral cavity (p = 0.003) and fever > 37.8°C (p = 0.005). Hospitalization costs in this group were up to 30% higher. The introduction of oral care by a multidisciplinary staff including laser therapy helps reduce morbidity resulting from OM and, consequently, helps minimize hospitalization costs associated with HSCT, even considering therapy costs.
口腔黏膜炎（OM）是造血干细胞移植（HSCT）的副作用之一，会导致严重的发病率。本研究旨在确定引入包括激光治疗在内的专门口腔护理方案对接受 HSCT 的患者的 OM 相关发病率的成本效益。对 167 名接受 HSCT 的患者进行了临床信息收集，并根据是否存在（n=91）或不存在（n=76）激光治疗和口腔护理进行了分组。成本分析包括每日住院费用、肠外营养（PN）和阿片类药物处方。结果发现，未接受激光治疗的组（组 II）表现出更高频率的严重 OM 程度（相对风险=16.8，95%置信区间-5.8 至 48.9，p<0.001），这种严重程度与 PN 使用（p=0.001）、阿片类药物处方（p<0.001）、口腔疼痛（p=0.003）和体温>37.8°C（p=0.005）之间存在显著关联。该组的住院费用增加了 30%。多学科工作人员引入口腔护理，包括激光治疗，可以帮助降低 OM 导致的发病率，从而有助于最大限度地降低与 HSCT 相关的住院费用，即使考虑到治疗成本。
