Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
Department of Nutrition and Dysphagia Rehabilitation, Tamana Regional Health Medical Center, 2172 Tamana, Tamana, Kumamoto, 865-0005, Japan.
BMC Geriatr. 2020 Jan 28;20(1):26. doi: 10.1186/s12877-020-1429-z.
Poor oral health at hospital admission is a potential higher mortality risk predictor. We aimed to determine in-hospital mortality by assessing poor oral health using a validated tool.
A retrospective observational study was conducted in an acute care hospital, and 624 consecutive geriatric patients were included. Patients were divided into three groups according to oral health, stratified by the Oral Health Assessment Tool (OHAT) scores. Nutritional status, daily living activities, cognitive impairment, and comorbidities were collected as covariates. Univariate and multivariate analyses were performed to identify the relationship between oral health and survival.
The mean age was 83.8 ± 7.9 years, and 41% were males. Groups with an OHAT score equivalent to 0, 1-2, and ≥ 3 comprised 213, 206, and 205 patients, and 11 (5.2%), 13 (6.3%), and 37 (18.0%) of those patients died in the hospital, respectively. Patients in the OHAT score ≥ 3 group had higher mortality than those in the other groups (log-rank test: p = 0.012 for the OHAT = 0 group; p = 0.010 for the OHAT = 1-2 group after Bonferroni corrections). Patients in the OHAT score ≥ 3 group continued to have poor survival even after adjusting for confounders in the Cox's regression analysis (hazard ratio: 2.514, 95% confidence interval: 1.220-5.183, p = 0.012).
In geriatric patients, poor oral health at hospital admission was an independent in-hospital mortality predictor. Future studies on oral care intervention stratified by oral health conditions are warranted.
入院时口腔健康状况不佳是潜在的更高死亡率预测因素。我们旨在通过使用经过验证的工具评估口腔健康状况来确定院内死亡率。
对一家急性护理医院进行回顾性观察性研究，纳入了 624 名连续的老年患者。根据口腔健康状况，使用口腔健康评估工具 (OHAT) 评分将患者分为三组。收集营养状况、日常生活活动、认知障碍和合并症作为协变量。进行单变量和多变量分析以确定口腔健康与生存之间的关系。
平均年龄为 83.8 ± 7.9 岁，41%为男性。OHAT 评分为 0、1-2 和≥3 的组分别有 213、206 和 205 名患者，分别有 11（5.2%）、13（6.3%）和 37（18.0%）名患者在医院死亡。OHAT 评分≥3 组的患者死亡率高于其他组（对数秩检验：OHAT=0 组的 p=0.012；Bonferroni 校正后 OHAT=1-2 组的 p=0.010）。即使在校正了 Cox 回归分析中的混杂因素后，OHAT 评分≥3 组的患者的生存状况仍然较差（危险比：2.514，95%置信区间：1.220-5.183，p=0.012）。
在老年患者中，入院时口腔健康状况不佳是独立的院内死亡率预测因素。需要对根据口腔健康状况分层的口腔护理干预进行进一步研究。
