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牙周治疗降低慢性阻塞性肺疾病患者不良呼吸事件风险:一项倾向匹配队列研究。

Periodontal Treatment Reduces Risk of Adverse Respiratory Events in Patients With Chronic Obstructive Pulmonary Disease: A Propensity-Matched Cohort Study.

作者信息

Shen Te-Chun, Chang Pei-Ying, Lin Cheng-Li, Chen Chia-Hung, Tu Chih-Yen, Hsia Te-Chun, Shih Chuen-Ming, Hsu Wu-Huei, Sung Fung-Chang, Kao Chia-Hung

机构信息

From the Graduate Institute of Clinical Medicine Science (T-CS, P-YC, C-HC, C-HK), College of Medicine, China Medical University; Division of Pulmonary and Critical Care Medicine (T-CS, C-HC, C-YT, T-CH, C-HS, W-HH), Department of Internal Medicine, China Medical University Hospital; Department of Dentistry (P-YC), China Medical University Hospital; Management Office for Health Data (C-LL, F-CS, C-HK), China Medical University Hospital; Department of Health Services Administration (F-CS), China Medical University, Taichung, Taiwan; Mahidol University Faculty of Public Health (F-CS), Bangkok, Thailand; and Department of Nuclear Medicine and PET Center (C-HK), China Medical University Hospital, Taichung, Taiwan.

出版信息

Medicine (Baltimore). 2016 May;95(20):e3735. doi: 10.1097/MD.0000000000003735.

Abstract

Treatment of periodontal diseases has been associated with benefit outcomes for patients with chronic obstructive pulmonary disease (COPD). However, no population-based cohort study has been conducted. We evaluated this relationship by retrospective cohort study using a large population data.Using the National Health Insurance claims data of Taiwan, we identified 5562 COPD patients with periodontal diseases who had received periodontal treatment as the treatment group. The comparison group was selected at a 1:1 ratio matched by the propensity score estimated with age, sex, date of COPD diagnosis and periodontal treatment, and comorbidities. Both groups were followed up for 5 years to compare risks of acute exacerbation, pneumonia, and acute respiratory failure.The incidence rates of adverse respiratory events were significantly lower in the treatment group than in the comparison group: 3.79 versus 4.21 per 100 person-years for emergency room visits, 2.75 versus 3.65 per 100 person-years for hospitalizations, and 0.66 versus 0.75 per 100 person-years for intensive care unit admissions. The treatment group also had a 37% reduced risk of deaths (1.81 vs 2.87 per 100 person-years), with an adjusted hazard ratio of 0.57 (95% confidence interval 0.52-0.62).Periodontal treatment for COPD patients could reduce the risk of adverse respiratory events and mortality. The adequate periodontal health care is important for COPD patients with periodontal diseases.

摘要

牙周疾病的治疗已被证明对慢性阻塞性肺疾病(COPD)患者有有益的结果。然而,尚未进行基于人群的队列研究。我们使用大量人群数据通过回顾性队列研究评估了这种关系。

利用台湾国民健康保险理赔数据,我们确定了5562名患有牙周疾病且接受过牙周治疗的COPD患者作为治疗组。对照组按1:1比例选取,根据年龄、性别、COPD诊断日期、牙周治疗情况以及合并症估计的倾向得分进行匹配。两组均随访5年,以比较急性加重、肺炎和急性呼吸衰竭的风险。

治疗组不良呼吸事件的发生率显著低于对照组

急诊就诊率为每100人年3.79次对4.21次,住院率为每100人年2.75次对3.65次,重症监护病房入住率为每100人年0.66次对0.75次。治疗组的死亡风险也降低了37%(每100人年1.81次对2.87次),调整后的风险比为0.57(95%置信区间0.52 - 0.62)。

对COPD患者进行牙周治疗可降低不良呼吸事件和死亡率的风险。对于患有牙周疾病的COPD患者,适当的牙周保健很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c59/4902439/e04d32024e74/medi-95-e3735-g001.jpg

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