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口腔健康团队的存在是否会影响重症监护病房患者呼吸机相关性肺炎的发生率和死亡率?系统评价。

Does the presence of oral health teams influence the incidence of ventilator-associated pneumonia and mortality of patients in intensive care units? Systematic review.

作者信息

de Araújo Elza Cristina Farias, da Silva Rênnis Oliveira, Raymundo Maria Letícia Barbosa, Vieira Thiago Isidro, de Sousa Simone Alves, Santiago Bianca Marques, Cavalcanti Yuri Wanderley

机构信息

Department of Clinical and Social Dentistry, University of Paraíba (UFPB), Cidade Universitária, João Pessoa, Paraíba, Brazil.

出版信息

Spec Care Dentist. 2023 Jul-Aug;43(4):452-463. doi: 10.1111/scd.12785. Epub 2022 Oct 9.

Abstract

AIMS

To verify whether oral health teams influence the oral health status, ventilator-associated pneumonia incidence and mortality rate of patients in Intensive Care Units (ICU).

MATERIALS AND METHODS

Bibliographic searches were performed in PubMed, Scopus, Web of Science, Lilacs, Embase, Livivo, Open Grey, Academic Google, and Cochrane databases. The assessment of the methodological quality and risk of bias of the included studies and a random-effects meta-analysis to summarize relative risk data for ventilator-associated pneumonia (VAP) and mortality were performed. An analysis of the certainty of the evidence was performed for the main outcomes analyzed.

RESULTS

Records of 518 studies were analyzed by reading titles and abstracts. Five studies were included according to eligibility criteria. The meta-analysis showed that ICU patients undergoing dental care by an oral health team had a lower incidence of VAP (OR = 0.33; 95% CI: 014-0.76) but did not lower mortality rates (OR = 0.46 95% CI: 0.16-1.32). The certainty of the evidence was considered very low.

CONCLUSION

Dental care provided by oral health teams in a hospital environment did not influence oral health status or mortality, although it contributed to a reduction in VAP of patients admitted to the ICU.

摘要

目的

验证口腔健康团队是否会影响重症监护病房(ICU)患者的口腔健康状况、呼吸机相关性肺炎发病率和死亡率。

材料与方法

在PubMed、Scopus、Web of Science、Lilacs、Embase、Livivo、Open Grey、学术谷歌和Cochrane数据库中进行文献检索。对纳入研究的方法学质量和偏倚风险进行评估,并进行随机效应荟萃分析,以总结呼吸机相关性肺炎(VAP)和死亡率的相对风险数据。对分析的主要结局进行证据确定性分析。

结果

通过阅读标题和摘要分析了518项研究的记录。根据纳入标准纳入了5项研究。荟萃分析表明,由口腔健康团队进行牙科护理的ICU患者VAP发病率较低(OR = 0.33;95%CI:0.14 - 0.76),但死亡率未降低(OR = 0.46,95%CI:0.16 - 1.32)。证据确定性被认为非常低。

结论

在医院环境中,口腔健康团队提供的牙科护理虽有助于降低ICU患者的VAP,但未影响口腔健康状况或死亡率。

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