Department of Oral Surgery, School of Medicine, Toho University, Tokyo 143-8541, Japan.
Department of Oral & Maxillofacial Surgery, Tokyo Medical & Dental University, Tokyo 113-0034, Japan.
Int J Environ Res Public Health. 2021 Jun 10;18(12):6296. doi: 10.3390/ijerph18126296.
Perioperative oral management is widely recognized in the healthcare system of Japan. Conventionally, the surgeon refers patients with oral problems to a dental or oral surgery clinic in the hospital. However, frequent in-house referrals were found to increase the number of incoming patients resulting in unsustainable situations due to an insufficient workforce. In 2011, the Center for Perioperative Medicine was established at our hospital to function as a management gateway for patients scheduled to undergo surgery under general anesthesia. The "oral triage" system, wherein a dental hygienist conducts an oral screening to select patients who need preoperative oral hygiene and functional management, was established in 2012. A total of 37,557 patients who underwent surgery at our hospital from April 2010 to March 2019 (two years before and seven years after introducing the system) were evaluated in this study. The sustainability and effectiveness of introducing the system were examined in 7715 cancer surgery patients. An oral management intervention rate of 20% and a significant decrease in the incidence of postoperative pneumonia (aOR = 0.50, = 0.03) indicated that this system could be useful as a sustainable and developmental oral management strategy to manage surgical patients with minimal human resources.
日本的医疗体系广泛认可围手术期的口腔管理。传统上，外科医生会将有口腔问题的患者转介到医院的牙科或口腔外科诊所。然而，频繁的院内转介被发现会增加就诊人数，导致由于劳动力不足而出现不可持续的情况。2011 年，我们医院成立了围手术期医学中心，作为接受全身麻醉下手术的患者的管理门户。2012 年建立了“口腔分诊”系统，由一名口腔保健师进行口腔筛查，选择需要术前口腔卫生和功能管理的患者。本研究共评估了 2010 年 4 月至 2019 年 3 月期间在我院接受手术的 37557 名患者（系统引入前两年和后七年）。在 7715 名癌症手术患者中检查了引入该系统的可持续性和有效性。口腔管理干预率为 20%，术后肺炎发病率显著下降（aOR = 0.50， = 0.03），表明该系统可以作为一种可持续和发展性的口腔管理策略，以最少的人力资源管理手术患者。
