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牙周保健与急性心肌梗死住院的关系。

Association between periodontal care and hospitalization with acute myocardial infarction.

出版信息

J Am Dent Assoc. 2022 Aug;153(8):776-786.e2. doi: 10.1016/j.adaj.2022.02.003. Epub 2022 Apr 20.

Abstract

BACKGROUND

Each year there are 800,000 myocardial infarctions in the United States. There is an increased risk of hospitalization for acute myocardial infarction (AMI) for those with periodontal disease. Yet, there is a paucity of knowledge about downstream care of AMI and how this varies with periodontal care status. The authors' aim was to examine the association between periodontal care and AMI hospitalization and 30 days after acute care.

METHODS

Using the MarketScan database, the authors conducted a retrospective cohort study among patients with both dental insurance and medical insurance in 2016 through 2018 who were hospitalized for AMI in 2017.

RESULTS

There were 2,370 patients who had dental and medical coverage for 2016 through 2018 and received oral health care in 2016 through 2017 and had an AMI hospitalization in 2017. Forty-seven percent received regular or other oral health care, 7% received active periodontal care, and 10% received controlled periodontal care. More than one-third of patients (36%) did not have oral health care before the AMI hospitalization. After adjusting for patient characteristics, we found that patients in the controlled periodontal care group were significantly more likely to have visits during the 30 days after AMI hospitalization (adjusted odds ratio, 1.63; 95% CI, 1.07 to 2.47; P = .02).

CONCLUSIONS

We found that periodontal care was associated with more after AMI visits. This suggests that there is a benefit to incorporating oral health care and medical care to improve AMI outcomes.

PRACTICAL IMPLICATIONS

Needing periodontal care is associated with more favorable outcomes related to AMI hospitalization. Early intervention to ensure stable periodontal health in patients with risk factors for AMI could reduce downstream hospital resource use.

摘要

背景

美国每年有 80 万例心肌梗死。患有牙周病的人患急性心肌梗死(AMI)的住院风险增加。然而,对于 AMI 的下游护理以及牙周护理状况如何影响这方面的知识还很匮乏。作者的目的是研究牙周护理与 AMI 住院治疗以及急性治疗后 30 天的关系。

方法

作者使用 MarketScan 数据库,对 2016 年至 2018 年期间同时有牙科保险和医疗保险并于 2017 年因 AMI 住院的患者进行了回顾性队列研究。

结果

共有 2370 名患者在 2016 年至 2018 年期间有牙科和医疗保险,并在 2016 年至 2017 年期间接受了口腔保健治疗,并在 2017 年发生了 AMI 住院。47%的患者接受了常规或其他口腔保健治疗,7%的患者接受了积极的牙周保健治疗,10%的患者接受了控制牙周保健治疗。超过三分之一的患者(36%)在 AMI 住院前没有进行口腔保健。在调整了患者特征后,我们发现控制牙周保健组的患者在 AMI 住院后 30 天内就诊的可能性明显更高(调整后的优势比,1.63;95%CI,1.07 至 2.47;P =.02)。

结论

我们发现牙周保健与 AMI 后就诊次数增加有关。这表明将口腔保健和医疗保健相结合可以改善 AMI 结果。

实用意义

需要牙周保健与 AMI 住院治疗相关的结果更有利。早期干预以确保 AMI 高危患者的牙周健康稳定,可以减少下游医院资源的使用。

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