Department of Orthopaedics, Region Skåne Office for Hospitals in North-Eastern Skåne, Kristianstad, SE-291 85, Sweden.
Department of Health Sciences, Kristianstad University, Kristianstad, SE-291 88, Sweden.
Clin Interv Aging. 2023 Jul 19;18:1103-1113. doi: 10.2147/CIA.S410577. eCollection 2023.
Orthogeriatric hospitalised patients with fractures of the lower limb constitute a vulnerable population with increased risk of morbidity, polypharmacy, and mortality as well as impaired oral health. The aim of this cross-sectional study was to investigate whether any relationship existed between oral health issues in older orthopaedic patients and mortality.
The study population consisted of older orthopedic patients emergently admitted to a hospital in southern Sweden due to mainly fractures of the hip. Their oral health at admission was assessed by trained nurses using the revised oral assessment guide (ROAG), as well as examined by dental hygienists. Medical and demographic data were collected from medical records and mortality from the national population registry. Comorbidity was assessed using the Charlson Comorbidity Index (CCI). Data were analysed using foremost dichotomized data derived from mean values and then processed using multiple logistic regression adjusted for identified probable confounders.
Of the 187 study patients (≥65 years) with a mean age of 81 (SD 7.9) years, 71% were women, mean CCI score was 6.7 and 90-days mortality 12.3%. Oral health issues (ROAG >8, 73%) consisted mainly of problems with teeth/dentures (41%), tongue (36%), lips (35%), and saliva (28%). In patients with any oral health impairment (ROAG >8) the 90-days mortality was significantly increased (p=0.040), using logistic regression analysis adjusted for age, gender, comorbidity, and use of ≥5 drugs. In patients with a ROAG score ≥10 (≥mean) the association remained at 90-days (p=0.029) and 180-days (p=0.013). Decayed teeth were present in 24% and was significantly associated with ROAG >8 (p=0.020).
The main finding of this study was a possible relationship between oral health impairment at admission and early mortality in orthogeriatric hospitalised patients. The opportunity to identify their oral health problems can help improving further care planning and care.
下肢骨折的老年骨科住院患者构成了一个脆弱的群体，他们的发病率、药物滥用、死亡率以及口腔健康状况都有所增加。本横断面研究的目的是调查老年骨科患者的口腔健康问题与死亡率之间是否存在任何关系。
研究人群为因髋部骨折而紧急入住瑞典南部一家医院的老年骨科患者。他们的口腔健康状况由经过培训的护士使用改良口腔评估指南（ROAG）进行评估，并由口腔卫生员进行检查。从病历中收集医疗和人口统计学数据，并从国家人口登记处获取死亡率。使用 Charlson 合并症指数（CCI）评估合并症。数据首先使用来自平均值的二分数据进行分析，然后使用经确定的可能混杂因素调整后的多变量逻辑回归进行处理。
在 187 名研究患者（≥65 岁）中，平均年龄为 81（SD 7.9）岁，71%为女性，平均 CCI 评分为 6.7，90 天死亡率为 12.3%。口腔健康问题（ROAG>8，73%）主要包括牙齿/假牙问题（41%）、舌头问题（36%）、嘴唇问题（35%）和唾液问题（28%）。在任何口腔健康受损（ROAG>8）的患者中，90 天死亡率显著增加（p=0.040），使用调整年龄、性别、合并症和使用≥5 种药物的逻辑回归分析。在 ROAG 评分≥10（≥平均值）的患者中，这种关联在 90 天（p=0.029）和 180 天（p=0.013）时仍然存在。有 24%的患者有龋齿，与 ROAG>8 显著相关（p=0.020）。
本研究的主要发现是老年骨科住院患者入院时口腔健康受损与早期死亡率之间可能存在关系。有机会识别他们的口腔健康问题可以帮助改善进一步的护理计划和护理。
