哪些因素可预测长时间气管插管后严重 COVID-19 幸存者的颅颌面部紊乱？

What factors predict craniomandibular disorders in severe COVID-19 survivors after prolonged intubation?

机构信息

Department of Oral and Craniomaxillofacial Plastic Surgery, Faculty of Medicine, University Hospital of Giessen and Marburg, UKGM GmbH, Campus Marburg, Philipps-University of Marburg, Marburg, Germany.

Department of Statistics, Chulalongkorn Business School, Chulalongkorn University, Bangkok, Thailand.

出版信息

J Stomatol Oral Maxillofac Surg. 2022 Nov;123(6):e631-e638. doi: 10.1016/j.jormas.2022.07.004. Epub 2022 Jul 7.

DOI:10.1016/j.jormas.2022.07.004

PMID:35809797

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9259603/

Abstract

PURPOSES

To estimate and identify predictors of craniomandibular disorders (CMDs) in severe COVID-19 survivors after prolonged intubation ≥ 1 week (SCOVIDS-PI).

METHODS

This retrospective study enrolled two cohorts of SCOVIDS-PIs with vs. without CMD during a one-year period. The predictor variables were demographic, dental, anesthetic, and laboratory parameters. The main outcome was presence of CMD until six post-PI months (yes/no). Appropriate statistics were computed with α = 95%.

RESULTS

The sample comprised 176 subjects aged 59.2 ± 17.2 years (range, 27-89; 11.9% with CMDs; 30.1% females). CMDs were significantly associated with (1) bilateral posterior tooth loss (P = 0; number needed to screen [NNS] = 1.6), (2) dentofacial skeletal class II/convex face (P = .01; NNS = 2.2), and (3) peak CRP during intensive care ≥ 40 mg/l (P = .01; NNS = 3.5). With combined predictors, NNS became 2 to 4.3.

CONCLUSIONS

Three predictors of CMDs in SCOVIDS-PIs: bilateral molar loss, convex face, and CRP ≥ 40 mg/l, indicate CMD screening and/or referral to a CMD specialist, regardless of patients' age, gender, underlying CMDs, or previous dental checkups. Screening ∼2 to 4 "SCOVIDS-PIs with ≥ one predictor" will identify one CMD events/patients during the first six post-PI months.

摘要

目的

评估和识别严重 COVID-19 幸存者（SCOVIDS）在长时间插管（≥1 周）后发生颅颌面部紊乱（CMD）的预测因素。

方法

本回顾性研究纳入了 SCOVIDS-PI 队列，在 1 年期间，比较了伴有 CMD 与不伴有 CMD 的 SCOVIDS-PI。预测变量为人口统计学、牙科、麻醉和实验室参数。主要结局是在 PI 后 6 个月时是否存在 CMD（是/否）。使用α=95%进行了适当的统计分析。

结果

样本包括 176 名年龄为 59.2±17.2 岁（范围 27-89 岁；11.9%有 CMD；30.1%为女性）的受试者。CMD 与（1）双侧后牙缺失（P=0；筛查所需人数 [NNS]为 1.6）、（2）牙颌面骨骼 II 类/凸面（P=0.01；NNS 为 2.2）和（3）重症监护期间峰值 CRP≥40mg/l（P=0.01；NNS 为 3.5）显著相关。结合预测因素，NNS 为 2 至 4.3。

结论

SCOVIDS-PI 中 CMD 的三个预测因素：双侧磨牙缺失、凸面和 CRP≥40mg/l，表明需要进行 CMD 筛查和/或转介至 CMD 专科医生，无论患者年龄、性别、潜在 CMD 或之前的牙科检查如何。筛查约 2 至 4 名“有≥1 个预测因素的 SCOVIDS-PI”，将在 PI 后 6 个月内识别出 1 例 CMD 事件/患者。