Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Dental Clinic, Kitagawa Hospitals, Okayama, Japan.
Gerodontology. 2019 Sep;36(3):236-243. doi: 10.1111/ger.12402. Epub 2019 Mar 22.
To identify significant risk factors associated with incidence of mortality and pneumonia in whole-community-based older inpatients resident in Japanese rural region.
Patients older than 65 years admitted between 1 April and 15 April 2010 to a core hospital located in a rural region were exhaustively recruited, and incidence of mortality and pneumonia during the 32-month follow-up period were evaluated. Independent variables at baseline measurement included age, gender, body mass index, Charlson comorbidity index, functional dependency, oral self-care ability index, number of remaining teeth, hyposalivation and nutritional status. Dependent variables were incidence of mortality and pneumonia. Survival and non-pneumonia curves were drawn using Kaplan-Meier analysis. Cox proportional hazards analysis was performed to identify the risk factors related to incidence of mortality and pneumonia.
The survival rate of 46 patients (male/female: 11/35; mean age: 83.8 ± 6.8 years) was 52.1%, and the incidence of pneumonia was 60.9%. Malnutrition and gender (male) were identified as significant risk factors for mortality (odds ratio [OR]: 8.18 and 4.90; 95% confidence interval [CI]: 1.77-37.3 and 1.50-16.0; P < 0.01 and <0.01, respectively). Loss of oral self-care ability and gender (male) were identified as significant risk factors for incidence of pneumonia (OR: 8.97 and 4.58; 95% CI: 1.70-47.4 and 1.50-14.0; P = 0.01 and <0.01, respectively).
Malnutrition and loss of oral self-care ability were significant risk factors for incidence of mortality and pneumonia, respectively. In response, supplying nutrition with appropriate diet and personalised oral care might contribute to reduction in mortality and prevention of pneumonia.
确定与日本农村地区全人群住院老年人死亡率和肺炎发病率相关的显著危险因素。
对 2010 年 4 月 1 日至 4 月 15 日期间入住位于农村地区核心医院的 65 岁以上患者进行全面招募，并在 32 个月的随访期间评估死亡率和肺炎发病率。基线测量的自变量包括年龄、性别、体重指数、Charlson 合并症指数、功能依赖、口腔自理能力指数、剩余牙齿数、低唾液分泌和营养状况。因变量为死亡率和肺炎发病率。使用 Kaplan-Meier 分析绘制生存和非肺炎曲线。采用 Cox 比例风险分析确定与死亡率和肺炎发病率相关的危险因素。
46 例患者（男/女：11/35；平均年龄：83.8±6.8 岁）的生存率为 52.1%，肺炎发病率为 60.9%。营养不良和性别（男）是死亡率的显著危险因素（比值比[OR]：8.18 和 4.90；95%置信区间[CI]：1.77-37.3 和 1.50-16.0；P<0.01 和<0.01）。丧失口腔自理能力和性别（男）是肺炎发病率的显著危险因素（OR：8.97 和 4.58；95%CI：1.70-47.4 和 1.50-14.0；P=0.01 和<0.01）。
营养不良和丧失口腔自理能力分别是死亡率和肺炎发病率的显著危险因素。因此，提供适当饮食和个性化口腔护理的营养可能有助于降低死亡率和预防肺炎。
