Almondes Camila Maria Simas, Souza Luana Carneiro Diniz, Leite Danielly de Fátima Castro, Rodrigues Vandilson Pinheiro, Lopes Fernanda Ferreira, Cruz Maria Carmen Fontoura Nogueira da
Postgraduate Dentistry Program, Federal University of Maranhão, São Luís, Maranhão, Brazil.
Department of Dentistry, State University of Maringá, Maringá, Paraná, Brazil.
J Int Acad Periodontol. 2017 Oct 1;19(4):110-117.
This study tested the hypothesis that a relationship exists between periodontal disease status and ventilator-associated pneumonia (VAP) in patients admitted to an intensive care unit (ICU).
The periodontal status of 60 individuals admitted to the ICU of the Dutra University Hospital was determined, including measurement of visible plaque, gingival bleeding, and clinical attachment level. Data were analyzed by Chi-square or Fisher's exact tests, unpaired Student's t-test and multivariate logistic regression.
Patients with VAP showed higher prevalence of periodontitis (25%) than those in the control group (12.5%), but without statistical difference (p = 0.22). After multivariate analysis, risk factors for ventilator-associated pneumonia included diabetes mellitus (OR = 27.76, 95% CI = 1.95-393, p = 0.014), and mechanical ventilation for longer than 10 days (OR = 12.1, 95% CI = 1.65-87.9, p = 0.014).
Within the limits of this study, no association between periodontitis and ventilator-associated pneumonia was found. The presence of diabetes and invasive mechanical ventilation duration (> 10 days) were risk factors for pneumonia even after the adjustment of variables.
本研究检验了重症监护病房（ICU）患者的牙周疾病状态与呼吸机相关性肺炎（VAP）之间存在关联这一假设。
对入住杜特拉大学医院ICU的60名患者的牙周状况进行了测定，包括对可见菌斑、牙龈出血和临床附着水平的测量。数据通过卡方检验或费舍尔精确检验、非配对学生t检验和多因素逻辑回归进行分析。
VAP患者的牙周炎患病率（25%）高于对照组（12.5%），但无统计学差异（p = 0.22）。多因素分析后，呼吸机相关性肺炎的危险因素包括糖尿病（OR = 27.76，95% CI = 1.95 - 393，p = 0.014）以及机械通气超过10天（OR = 12.1，95% CI = 1.65 - 87.9，p = 0.014）。
在本研究范围内，未发现牙周炎与呼吸机相关性肺炎之间存在关联。即使在变量调整后，糖尿病的存在和有创机械通气时间（> 10天）仍是肺炎的危险因素。
