Noguchi Shingo, Yatera Kazuhiro, Kato Tatsuji, Chojin Yasuo, Furuta Norihiko, Akata Kentaro, Kawanami Toshinori, Yoshii Chiharu, Mukae Hiroshi
Department of Respiratory Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.
Department of Respiratory Medicine, Tobata Kyoritsu Hospital, Kitakyushu, Fukuoka, Japan.
Gerodontology. 2018 Jun;35(2):110-116. doi: 10.1111/ger.12324. Epub 2018 Feb 15.
To investigate the significance of comprehensive assessment of oral health using the revised oral assessment guide (ROAG) in older adults with pneumonia.
Oral health plays a major role in the eating-swallowing process. The role of comprehensive assessment of oral health in older adults with aspiration pneumonia has not been evaluated in detail. The ROAG is a screening tool for comprehensive assessment and has been shown to have a high sensitivity and specificity for the assessment of oral health.
We retrospectively studied 238 adults with pneumonia, aged 65 years and above, in whom the ROAG score had been assessed between December 2014 and June 2016. Participants were divided into two groups based on aspiration risk, as defined by Marik et al; correlation between the ROAG score and the risk of aspiration was evaluated.
Two hundred and fifteen adults (90.3%) were found to be at aspiration risk. According to the ROAG score, mild-to-moderate and severe oral problems were noted in 38 (16.0%) and 200 (84.0%) adults, respectively. Aspiration risk was noted in 68.4% and 94.5% of adults with mild-to-moderate and severe oral problems, respectively (P < .0001). The area under the receiver operating characteristics curve for ROAG to predict aspiration risk was 0.72 (95% confidence interval: 0.60-0.84). Furthermore, a high ROAG score was an independent predictor of aspiration risk in our study population.
In clinical practice, oral health assessment using ROAG can help predict aspiration risk in older adults with pneumonia.
探讨使用修订后的口腔评估指南（ROAG）对老年肺炎患者进行口腔健康综合评估的意义。
口腔健康在进食吞咽过程中起主要作用。口腔健康综合评估在老年吸入性肺炎患者中的作用尚未得到详细评估。ROAG是一种用于综合评估的筛查工具，已被证明在口腔健康评估中具有较高的敏感性和特异性。
我们回顾性研究了2014年12月至2016年6月期间238例年龄在65岁及以上的肺炎成年患者，这些患者的ROAG评分已被评估。根据Marik等人定义的误吸风险将参与者分为两组；评估ROAG评分与误吸风险之间的相关性。
发现215名成年人（90.3%）有误吸风险。根据ROAG评分，分别有38名（16.0%）和200名（84.0%）成年人存在轻度至中度和重度口腔问题。轻度至中度和重度口腔问题的成年人中，误吸风险分别为68.4%和94.5%（P <.0001）。ROAG预测误吸风险的受试者工作特征曲线下面积为0.72（95%置信区间：0.60 - 0.84）。此外，在我们的研究人群中，高ROAG评分是误吸风险的独立预测因素。
在临床实践中，使用ROAG进行口腔健康评估有助于预测老年肺炎患者的误吸风险。
