Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
Department of General Medicine, Faculty of Medicine, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan.
Eur Geriatr Med. 2024 Apr;15(2):489-496. doi: 10.1007/s41999-023-00917-4. Epub 2024 Jan 12.
To investigate the effects of oral health status at admission on in-hospital outcomes and how it varies during hospitalization in older patients with aspiration pneumonia.
This prospective cohort study involved patients aged ≥ 65 years who were admitted to an acute care hospital with a diagnosis of aspiration pneumonia. The patients' basic health information, length of hospital stay (LOS), and oral health assessment tool (OHAT), functional oral intake scale (FOIS), pneumonia severity index, and clinical frailty scale scores were recorded. Patients were divided into two groups based on their median OHAT scores, and intergroup changes were analyzed as a function of time. The relationship between the LOS, FOIS score upon discharge, and OHAT scores at admission was examined using multiple regression analysis.
Of the 89 participants (52 were men, with a mean age of 84.8 ± 7.9 years), 75 were discharged. The patients' oral health was measured weekly for 3 weeks after the initial assessment via the OHAT, wherein the median score was 7, with a significant between-group difference. Moreover, OHAT scores improved within both groups throughout their stay. OHAT scores at admission were independently associated with the LOS (B = 5.51, P = 0.009).
Poor oral health status at admission was associated with longer hospital stays. Both the high- and low-OHAT groups showed OHAT score improvements. Oral health status is critical in preventing the onset of and treating aspiration pneumonia.
探讨入院时口腔健康状况对老年吸入性肺炎患者住院期间的影响,并分析其在住院期间的变化。
本前瞻性队列研究纳入了年龄≥65 岁、因吸入性肺炎入住急性护理医院的患者。记录了患者的基本健康信息、住院时间(LOS)、口腔健康评估工具(OHAT)、功能性口腔摄入量表(FOIS)、肺炎严重指数和临床虚弱评分。根据 OHAT 中位数将患者分为两组,并分析组间随时间的变化。使用多元回归分析探讨 LOS、出院时 FOIS 评分与入院时 OHAT 评分之间的关系。
在 89 名参与者中(52 名男性,平均年龄 84.8±7.9 岁),有 75 名患者出院。通过 OHAT 每周对患者的口腔健康进行 3 周的初始评估后测量,中位数评分为 7,两组间存在显著差异。此外,两组患者的 OHAT 评分在住院期间均有所改善。入院时的 OHAT 评分与 LOS 独立相关(B=5.51,P=0.009)。
入院时口腔健康状况较差与住院时间延长有关。高和低 OHAT 组的 OHAT 评分均有所改善。口腔健康状况对预防和治疗吸入性肺炎至关重要。