Department of Dental Surgery, Kumamoto Rehabilitation Hospital, Kumamoto, Japan.
Department of Rehabilitation Medicine, Kumamoto Rehabilitation Hospital, Kumamoto, Japan.
Clin Nutr. 2019 Dec;38(6):2677-2683. doi: 10.1016/j.clnu.2018.11.020. Epub 2018 Nov 30.
BACKGROUND & AIMS: Oral health is an integral part of nutrition and rehabilitation. The purpose of this study was to investigate the impact of impaired oral health status on clinical and functional outcomes in post-acute in-hospital rehabilitation.
We conducted a prospective cohort study of hospitalized patients undergoing rehabilitation at a 225-bed post-acute rehabilitation hospital in Japan. All newly admitted patients were eligible to enroll during the two-year research period. Oral health status was evaluated on admission using the Revised Oral Assessment Guide (ROAG). Nutritional status, assessed using the Mini Nutritional Assessment-Short Form; activities of daily living, assessed by Functional Independence Measure motor scores; home discharge; all-cause in-hospital mortality; and length of hospital stay were measured as clinical and rehabilitation outcomes. Multivariate analyses were used to determine whether the ROAG score on admission was associated with these outcomes at discharge.
Of the 1066 patients enrolled, 1056 were included in the final analysis. The mean age was 70 ± 17 years. Fifty-two percent of patients were women. Stroke (21.7%) and musculoskeletal disorders (30.5%) were the most common reasons for admission. Slight or moderate to severe oral health problems were detected in 609 (57.7%) and 163 (15.4%) patients, respectively. Eighteen patients died during hospitalization. The ROAG score at admission was independently associated with Functional Independence Measure motor scores at discharge (P = 0.022), home discharge (P = 0.005), in-hospital mortality (P = 0.039), and length of hospital stay (P = 0.045), after adjusting for potential confounders.
Impaired oral health status may be associated with rehabilitation outcomes in hospitalized patients. Early detection of oral health problems and treatment by dental professionals, or through cooperation between medical and dental professionals, should be implemented in these patients.
口腔健康是营养和康复的一个组成部分。本研究旨在调查急性住院康复后，口腔健康状况受损对临床和功能结局的影响。
我们对日本一家 225 张床位的急性后康复医院住院康复的患者进行了前瞻性队列研究。在两年的研究期间，所有新入院的患者都有资格参加。入院时使用修订后的口腔评估指南（ROAG）评估口腔健康状况。使用迷你营养评估-简短表格评估营养状况；使用功能独立性测量运动评分评估日常生活活动能力；使用家庭出院；全因住院死亡率；以及住院时间作为临床和康复结局。使用多变量分析确定入院时 ROAG 评分与出院时这些结局是否相关。
在纳入的 1066 名患者中，有 1056 名患者纳入最终分析。患者的平均年龄为 70±17 岁。52%的患者为女性。卒中（21.7%）和肌肉骨骼疾病（30.5%）是最常见的入院原因。分别有 609 名（57.7%）和 163 名（15.4%）患者存在轻度或中度至重度口腔健康问题。18 名患者在住院期间死亡。入院时的 ROAG 评分与出院时的功能独立性测量运动评分（P=0.022）、家庭出院（P=0.005）、住院死亡率（P=0.039）和住院时间（P=0.045）独立相关，在调整了潜在混杂因素后。
口腔健康状况受损可能与住院患者的康复结局相关。应在这些患者中通过口腔专业人员早期发现口腔健康问题并进行治疗，或通过医疗和口腔专业人员之间的合作来实现。
