Department of Nutrition and Speech-Language Therapy, Clinic of Rehabilitation, St. Olavs hospital - Trondheim University Hospital, Trondheim, Norway; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
Clinic of Surgery, Namsos Hospital, Nord-Trøndelag Hospital Trust, Namsos, Norway.
Clin Nutr ESPEN. 2023 Oct;57:527-536. doi: 10.1016/j.clnesp.2023.07.088. Epub 2023 Jul 31.
BACKGROUND & AIMS: Hospitalised patients are especially vulnerable to malnutrition, which is associated with an increased risk of complications, leading to longer hospital stays, increased healthcare costs, and with a potentially negative effect on the prognosis. Poor oral health may make food intake difficult and contribute to poor nutritional status. The aim of the present cross-sectional study was to assess the occurrence of poor oral health and malnutrition in adult hospitalised patients, and further to investigate associations between oral health problems and malnutrition.
The Patient-Generated Subjective Global Assessment (PG-SGA) determined the patients' nutritional status. The oral health condition was evaluated according to the Revised Oral Assessment Guide-Jönköping (ROAG-J) and unstimulated salivary flow rate. Clinical information was collected from medical records.
The study population included 118 patients from 15 somatic and 3 psychiatric wards at a University Hospital in Norway. Nearly half the patients (46%) were categorised as malnourished and in need of symptom alleviation or nutritional intervention. Malnutrition was found in all diagnostic conditions. According to ROAG-J, at least one oral health problem was identified in 93% of the patients. Severe oral health problems were more frequent in malnourished patients. Overall, both the number and total score of oral health problems were associated with malnutrition (OR 1.57, 95% CI 1.20-2.06 and OR 1.47, 95% CI 1.17-1.83, respectively). Of specific oral health items, problems with lips and mucous membranes were significantly associated with malnutrition. One-fifth of all patients had hyposalivation, but this was not associated with malnutrition.
Oral health problems and malnutrition are commonly seen in hospitalised adult patients. The association between the two calls for raised awareness of oral health issues in assessing patients' nutritional status. Further study is required to clarify whether oral health problems constitute a causal factor in malnutrition.
住院患者尤其容易出现营养不良，这会增加并发症的风险，导致住院时间延长、医疗费用增加，并可能对预后产生负面影响。口腔健康状况不佳可能使进食困难，并导致营养状况不佳。本横断面研究的目的是评估成年住院患者的口腔健康不良和营养不良的发生情况，并进一步探讨口腔健康问题与营养不良之间的关系。
采用患者主观整体评估量表（PG-SGA）评估患者的营养状况。口腔健康状况根据修订后的约翰松口腔评估指南（ROAG-J）和非刺激性唾液流率进行评估。临床信息从病历中收集。
该研究人群包括来自挪威一所大学医院的 15 个躯体病房和 3 个精神科病房的 118 名患者。近一半的患者（46%）被归类为营养不良，需要缓解症状或进行营养干预。在所有诊断情况下均发现营养不良。根据 ROAG-J，93%的患者至少存在一个口腔健康问题。营养不良患者的口腔健康问题更严重。总体而言，口腔健康问题的数量和总评分均与营养不良相关（OR 1.57，95%CI 1.20-2.06 和 OR 1.47，95%CI 1.17-1.83）。在特定的口腔健康项目中，嘴唇和黏膜问题与营养不良显著相关。五分之一的患者存在唾液分泌减少，但与营养不良无关。
口腔健康问题和营养不良在住院成年患者中很常见。两者之间的关联需要提高对评估患者营养状况时口腔健康问题的认识。需要进一步研究以阐明口腔健康问题是否构成营养不良的因果因素。
