Steinle Erika Caroline, Pinesso Jessica Antonia Montovani, Bellançon Leonardo Bernardi, de Paula Ramos Solange, Seixas Gabriela Fleury
Research Group On Tissue Regeneration, Adaptation, and Repair, Center of Biological Sciences, State University of Londrina, Londrina, PR, Brazil.
Research Group On Tissue Regeneration, Adaptation, and Repair, North Parana University, Rua Marselha, Londrina, 678, Brazil.
Clin Oral Investig. 2023 Jul;27(7):3875-3884. doi: 10.1007/s00784-023-05008-z. Epub 2023 Apr 5.
To analyze the relationship between the oral and systemic health status of adult patients admitted to the intensive care unit (ICU) with the length of stay and mortality.
A daily oral examination and oral hygiene were performed in patients admitted to an adult ICU. Dental and oral lesions, systemic health status, the need for mechanical ventilation, length of stay, and mortality were registered. Multivariate linear and logistic regression analyses were performed to identify associations between length of stay and death of patients, respectively, with oral and systemic health status.
In total, 207 patients were included, 107 (51.7%) male. Ventilated patients presented an increased length of stay (p < 0.001), mortality (p < 0.0001), number of medications (p < 0.0001), edentulism (p = 0.001), mucous lesions and bleeding (p < 0.0001), oropharyngitis (p = 0.03), and drooling (p < 0.001) compared to non-ventilated patients. The number of days in the ICU was associated with mechanical ventilation (p = 0.04), nosocomial pneumonia (p = 0001), end-stage renal disease (p < 0.0007), death (p < 0.0001), mucous bleeding (p = 0.01), tongue coating (p = 0.001), and cheilitis (p = 0.01). Mortality was associated with length of stay in the ICU (p < 0.0001), number of medications (p < 0.0001), and the need for mechanical ventilation (p = 0.006).
ICU patients present poor oral health. Soft tissue biofilm and mucous ulcerations were associated with the length of stay in the ICU, but not with the mortality rate.
Mucous lesions are associated with an increased length of stay in the ICU, and critically ill patients should receive oral care to control oral foci of infection and mucous lesions.
分析入住重症监护病房（ICU）的成年患者口腔与全身健康状况与住院时间及死亡率之间的关系。
对入住成人ICU的患者进行每日口腔检查及口腔卫生护理。记录牙齿和口腔病变、全身健康状况、机械通气需求、住院时间及死亡率。分别进行多变量线性回归和逻辑回归分析，以确定患者住院时间和死亡与口腔及全身健康状况之间的关联。
共纳入207例患者，其中107例（51.7%）为男性。与未接受机械通气的患者相比，接受机械通气的患者住院时间延长（p < 0.001）、死亡率升高（p < 0.0001）、用药数量增加（p < 0.0001）、无牙情况更多（p = 0.001）、黏膜病变及出血更多（p < 0.0001）、口咽炎更多（p = 0.03）、流涎更多（p < 0.001）。在ICU的住院天数与机械通气（p = 0.04）、医院获得性肺炎（p = 0.001）、终末期肾病（p < 0.0007）、死亡（p < 0.0001）、黏膜出血（p = 0.01）、舌苔（p = 0.001）及唇炎（p = 0.01）相关。死亡率与在ICU的住院时间（p < 0.0001）、用药数量（p < 0.0001）及机械通气需求（p = 0.006）相关。
ICU患者口腔健康状况较差。软组织生物膜和黏膜溃疡与在ICU的住院时间相关，但与死亡率无关。
黏膜病变与在ICU的住院时间延长相关，重症患者应接受口腔护理以控制口腔感染灶和黏膜病变。
