Geriatric Dentistry, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ohta-ku, Tokyo 145-8515, Japan.
Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.
Int J Environ Res Public Health. 2021 Nov 8;18(21):11725. doi: 10.3390/ijerph182111725.
This study aimed to evaluate the role of the general condition and oral health status in determining the primary nutritional route and suitable food form for oral ingestion among malnourished inpatients. This cross-sectional study included 255 inpatients referred to a nutrition support team (NST), which included dental professionals, at an acute care hospital. We assessed the participants' basic information, and Dysphagia Severity Scale (DSS) and Oral Health Assessment Tool (OHAT) scores. The nutritional intake mode was evaluated based on the Functional Oral Intake Scale scores at the initial NST consultation (FOIS-I), and then revised by the NST based on the participants' general condition and oral health (FOIS-R). There was a divergence between FOIS-I and FOIS-R, with FOIS-R being significantly higher than FOIS-I ( < 0.001). Logistic regression analysis of FOIS-R identified that consciousness level (odds ratio (OR): 0.448; 95% confidence interval (CI): 0.214-0.935) and DSS (OR: 3.521; 95% CI: 2.574-4.815) significantly affected the oral nutrition intake. Among participants who could ingest orally (FOIS-R ≥ 3; = 126), FOIS score had significant negative and positive associations with the OHAT and DSS scores, respectively. These findings suggest that appropriate assessment of oral health status, including swallowing function, might contribute to high-quality nutrition management.
本研究旨在评估一般状况和口腔健康状况在确定营养不良住院患者的主要营养途径和适合口服的食物形式中的作用。这是一项横断面研究,共纳入 255 名因营养不良而转至急性护理医院营养支持小组(NST)的住院患者,其中包括牙科专业人员。我们评估了参与者的基本信息、吞咽困难严重程度量表(DSS)和口腔健康评估工具(OHAT)评分。根据初始 NST 咨询时的功能性口腔摄入量表评分(FOIS-I)评估营养摄入模式,然后由 NST 根据参与者的一般状况和口腔健康进行修订(FOIS-R)。FOIS-I 和 FOIS-R 之间存在差异,FOIS-R 明显高于 FOIS-I(<0.001)。FOIS-R 的逻辑回归分析表明,意识水平(比值比(OR):0.448;95%置信区间(CI):0.214-0.935)和 DSS(OR:3.521;95% CI:2.574-4.815)显著影响口服营养摄入。在能够口服摄入(FOIS-R≥3;n=126)的参与者中,FOIS 评分与 OHAT 和 DSS 评分分别呈显著负相关和正相关。这些发现表明,对口健康状况的适当评估,包括吞咽功能,可能有助于高质量的营养管理。