Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan; Department of Dentistry, China Medical University Hospital, Taichung, Taiwan.
Eur J Intern Med. 2017 Dec;46:56-60. doi: 10.1016/j.ejim.2017.06.005. Epub 2017 Jun 7.
Periodontal disease is prevalent in asthmatics, but it is unclear whether periodontal treatment plays a role in adverse respiratory events in these patients. We evaluated risk of hospitalization for adverse respiratory events (acute exacerbation, pneumonia, and acute respiratory failure) and mortality in asthmatic adults with and without periodontal treatment.
We used National Health Insurance (NHI) claims data of Taiwan to identify 4771 asthmatic adults with periodontal disease who underwent periodontal treatment during 2000-2006. The control group consisted of asthmatic adults without periodontal disease at a 1:1 ratio matched by the propensity score. Both groups were followed up for 5years to estimate the risk of hospitalization for adverse respiratory events and mortality.
Compared with controls, the periodontal treatment group had lower overall incidence of hospitalization for adverse respiratory events [5.41 vs. 6.07 per 100 person-years, 95% confidence interval (CI)=0.78-0.92] and intensive care unit admissions (1.14 vs. 1.25 per 100 person-years, 95% CI=0.79-0.99). In addition, the all-cause mortality rate was significantly lower in the periodontal treatment group than in the control group during the follow-up period (1.86 vs. 2.79 per 100 person-years, 95% CI=0.59-0.71).
Asthmatic adults who underwent periodontal treatment were at lower risk of hospitalization for adverse respiratory events and mortality than those without periodontal disease. Asthmatic adults should adopt more precautionary oral hygiene and ensure that they undergo regular periodontal health checkups.
牙周病在哮喘患者中很常见,但目前尚不清楚牙周治疗是否会对这些患者的呼吸不良事件产生影响。我们评估了有和没有牙周治疗的哮喘成人患者发生不良呼吸事件(急性加重、肺炎和急性呼吸衰竭)和死亡的住院风险。
我们使用了台湾全民健康保险(NHI)的理赔数据,确定了 2000 年至 2006 年间接受牙周治疗的 4771 名患有牙周病的哮喘成人。对照组由在倾向评分匹配下按 1:1 比例选择的无牙周病的哮喘成人组成。两组均随访 5 年,以估计不良呼吸事件和死亡的住院风险。
与对照组相比,牙周治疗组不良呼吸事件的总住院率较低[5.41 比 6.07/100 人年,95%置信区间(CI)=0.78-0.92]和入住重症监护病房的人数也较低[1.14 比 1.25/100 人年,95%置信区间(CI)=0.79-0.99]。此外,在随访期间,牙周治疗组的全因死亡率明显低于对照组(1.86 比 2.79/100 人年,95%置信区间(CI)=0.59-0.71)。
与没有牙周病的患者相比,接受牙周治疗的哮喘成人发生不良呼吸事件和死亡的风险较低。哮喘患者应采取更谨慎的口腔卫生措施,并确保定期进行牙周健康检查。