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社区综合护理单元中老年患者吸入性肺炎的危险因素:一项回顾性队列研究

Risk Factors for Aspiration Pneumonia among Elderly Patients in a Community-Based Integrated Care Unit: A Retrospective Cohort Study.

作者信息

Uno Isao, Kubo Takaaki

机构信息

Sakurajyuji Hospital, 1-1-1 Mikoyokibe, Kumamoto Prefecture, Minami-ku, Kumamoto 861-4173, Japan.

Division of Health Sciences, Graduate School of Health Sciences, Kumamoto Health Science University, 325 Izumi-Machi, Kumamoto Prefecture, Kita-ku, Kumamoto 861-5598, Japan.

出版信息

Geriatrics (Basel). 2021 Nov 30;6(4):113. doi: 10.3390/geriatrics6040113.

Abstract

We aimed to clarify the physical factors associated with the incidence of aspiration pneumonia in a community-based integrated care unit. This retrospective cohort study included 412 patients aged 65 years or older admitted to a community-based integrated care unit. A new diagnosis of aspiration pneumonia made by the attending physician based on physical examination, imaging findings, and blood test data after 48 h of admission was considered as an incidence of aspiration pneumonia. Basic patient information, activities of daily living, swallowing function, nutritional status, cognitive function, oral health-related factors, and energy intake were retrospectively investigated. We classified the patients into a pneumonia group and a non-pneumonia group, and examined the factors associated with the development of aspiration pneumonia. The mean age was 86.9 ± 8.1 years, and the pneumonia group comprised 49 participants. Comparison between the groups showed significant differences in oral environment, denture use, cognitive functional independence measure, and discharge to home. In multivariate logistic regression analysis, oral environment (odds ratio (OR) = 0.229, 95% confidence interval (CI): 0.070-0.753, = 0.015) and use of dentures (OR = 0.360, 95% CI: 0.172-0.754, = 0.007) were independently associated with aspiration pneumonia. Oral care and the use of dentures may be effective in preventing aspiration pneumonia.

摘要

我们旨在阐明社区综合护理单元中与吸入性肺炎发病率相关的身体因素。这项回顾性队列研究纳入了412名65岁及以上入住社区综合护理单元的患者。主治医生根据入院48小时后的体格检查、影像学检查结果和血液检测数据新诊断出的吸入性肺炎被视为吸入性肺炎的发病情况。回顾性调查了患者的基本信息、日常生活活动、吞咽功能、营养状况、认知功能、口腔健康相关因素和能量摄入情况。我们将患者分为肺炎组和非肺炎组,并研究了与吸入性肺炎发生相关的因素。平均年龄为86.9±8.1岁,肺炎组包括49名参与者。两组之间的比较显示,在口腔环境、假牙使用、认知功能独立性测量和回家情况方面存在显著差异。在多因素逻辑回归分析中,口腔环境(比值比(OR)=0.229,95%置信区间(CI):0.070 - 0.753,P = 0.015)和假牙使用(OR = 0.360,95%CI:0.172 - 0.754,P = 0.007)与吸入性肺炎独立相关。口腔护理和假牙使用可能对预防吸入性肺炎有效。

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