King's College London, London, UK.
City University of London, London, UK.
Eur J Oral Sci. 2021 Feb;129(1):e12752. doi: 10.1111/eos.12752. Epub 2021 Feb 3.
In people with mental disorders, adverse general health is well recognized but dental diseases remain underinvestigated. The objective of this study was to investigate risk factors for hospital admissions for dental disorders in patients with severe mental illness (SMI) and/or depressive disorder. De-identified electronic mental health records from the South London and Maudsley NHS Foundation Trust (SLaM) were linked to national Hospital Episode Statistics (HES) data for analysis. Data were extracted for adults with a diagnosis of SMI (schizophrenia, schizoaffective disorder, bipolar disorder) and/or depression, who had received care at SLaM between 1 January 2010 and 31 March 2017. In the cohort of 18,999 patients thus obtained, the following factors were independently associated with hospital admission for dental disorders: female gender [odds ratio (OR) = 1.48, 95% CI: 1.31-1.68)], Health of the Nation Outcome Scales (HoNOS) problem drinking/drug taking (OR = 1.12, 95% CI: 1.05-1.19), HoNOS physical illness/disability (OR = 1.18, 95% CI: 1.12-.25), diabetes (OR = 1.24, 95% CI: 1.06-1.43), recorded current/past smoking (OR = 1.35, 95% CI: 1.06-1.43), treatment with antidepressant medication (OR = 1.48, 95% CI: 1.31-1.68), and depressive disorder (OR = 1.36, 95% CI: 1.11-1.68). Building on previous research in this population, which indicated a relatively high risk of acute care hospitalizations with dental disorders as discharge diagnoses, a number of demographic and clinical characteristics were found to be independent predictors over a 7-yr period. Further research into these predictors would facilitate a better understanding of how adverse dental outcomes might be prevented.
在患有精神障碍的人群中，不良的整体健康状况是众所周知的，但牙齿疾病仍然研究不足。本研究的目的是调查严重精神疾病（SMI）和/或抑郁症患者因牙科疾病住院的危险因素。从南伦敦和莫兹利国民保健信托基金会（SLaM）的匿名电子心理健康记录中提取数据，并与全国医院发病统计数据（HES）进行链接进行分析。该数据提取自 2010 年 1 月 1 日至 2017 年 3 月 31 日期间在 SLaM 接受治疗的患有 SMI（精神分裂症、分裂情感障碍、双相情感障碍）和/或抑郁症的成年人。在所获得的 18999 名患者队列中，以下因素与因牙科疾病住院独立相关：女性（优势比[OR] 1.48，95%可信区间[CI]：1.31-1.68））、国民健康服务结果量表（HoNOS）问题饮酒/吸毒（OR 1.12，95%CI：1.05-1.19）、HoNOS 身体疾病/残疾（OR 1.18，95%CI：1.12-.25）、糖尿病（OR 1.24，95%CI：1.06-1.43）、记录当前/过去吸烟（OR 1.35，95%CI：1.06-1.43）、抗抑郁药物治疗（OR 1.48，95%CI：1.31-1.68）和抑郁障碍（OR 1.36，95%CI：1.11-1.68）。在本人群中，之前的研究表明，以牙科疾病为出院诊断的急性护理住院风险相对较高，在此基础上，本研究还发现了一些人口统计学和临床特征在 7 年内是独立预测因素。进一步研究这些预测因素将有助于更好地了解如何预防不良的牙科结局。
