Department of Respiratory Medicine, Japanese Red Cross Society Saitama Hospital, 1-5 Shintoshin Chuo-ku Saitama-shi, Saitama, 330-8553, Japan.
Department of Pharmacotherapy, Research Institute of Pharmaceutical Sciences Musashino University, Tokyo, Japan.
BMC Infect Dis. 2019 Sep 2;19(1):761. doi: 10.1186/s12879-019-4327-2.
Aspiration pneumonia is a serious problem among elderly patients; it is caused by many risk factors including dysphagia, poor oral hygiene, malnutrition, and sedative medications. The aim of this study was to define a convenient procedure to objectively evaluate the risk of aspiration pneumonia in the clinical setting.
This prospective study included an aspiration pneumonia (AP) group, a community-acquired pneumonia (CAP) group, and a control (Con) group (patients hospitalized for lung cancer chemotherapy). We used the Oral Health Assessment Tool (OHAT), which assesses oral hygiene, and evaluated performance status, body mass index, serum albumin levels, substance P values in plasma, and oral bacterial counts.
The oral health as assessed by the OHAT of the aspiration pneumonia group was significantly impaired compared with that of the CAP group and the control (5.13 ± 0.18, 4.40 ± 0.26, 3.90 ± 0.22, respectively; p < 0.05). The oral bacterial count in the aspiration pneumonia group (7.20 ± 0.11) was significantly higher than that in the CAP group (6.89 ± 0.12), consistent with the OHAT scores. Oral bacterial count was significantly reduced by oral care.
OHAT and oral bacterial counts can be a tool to assess the requirement of taking oral care and other preventive procedures in patients at high risk of aspiration pneumonia.
吸入性肺炎是老年患者的严重问题；它是由许多风险因素引起的，包括吞咽困难、口腔卫生不良、营养不良和镇静药物。本研究旨在定义一种方便的程序，以在临床环境中客观评估吸入性肺炎的风险。
这项前瞻性研究包括吸入性肺炎（AP）组、社区获得性肺炎（CAP）组和对照组（因肺癌化疗住院的患者）。我们使用了口腔健康评估工具（OHAT），评估口腔卫生，并评估了身体状况、体重指数、血清白蛋白水平、血浆中 P 物质值和口腔细菌计数。
与 CAP 组和对照组相比，吸入性肺炎组的 OHAT 评估的口腔健康明显受损（分别为 5.13±0.18、4.40±0.26 和 3.90±0.22；p<0.05）。吸入性肺炎组（7.20±0.11）的口腔细菌计数明显高于 CAP 组（6.89±0.12），与 OHAT 评分一致。口腔护理可显著降低口腔细菌计数。
OHAT 和口腔细菌计数可以作为评估有吸入性肺炎风险的患者进行口腔护理和其他预防措施需求的工具。
