Department of Clinical Neuroscience and Therapeutics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami ward, Hiroshima, 734-8551, Japan.
Department of General Dentistry, Hiroshima University Hospital, Hiroshima, Japan.
Clin Oral Investig. 2024 Jul 19;28(8):434. doi: 10.1007/s00784-024-05833-w.
Oral care is crucial for the prevention of cardiovascular events and pneumonia. However, few studies have evaluated the associations between multidimensional assessments of oral status or functional outcomes and hospital-acquired pneumonia (HAP).
Consecutive patients with acute ischemic stroke (AIS) were retrospectively analyzed. We evaluated the modified oral assessment grade (mOAG) and investigated its association with a modified Rankin scale (mRS) score of 0‒2 (good stroke outcome) and HAP. The mOAG was developed to evaluate 8 categories (lip, tongue, coated tongue, saliva, mucosa, gingiva, preservation, and gargling) on a 4-point scale ranging from 0 to 3. We analyzed the effectiveness of the mOAG score for predicting stroke outcome or HAP using receiver operating characteristic (ROC) curve analysis.
In total, 247 patients with AIS were analyzed. The area under the ROC curve of the mOAG for predicting poor outcomes was 0.821 (cutoff value: 7), and that for HAP incidence was 0.783 (cutoff value: 8). mOAG (a one-point increase) was associated with poor stroke outcome (odds ratio [OR] 1.31, 95% confidence interval [CI] 1.17‒1.48, P < 0.001) and HAP (OR 1.21, 95% CI 1.07‒1.38, P = 0.003) after adjusting for baseline clinical characteristics, including age and stroke severity.
Lower mOAG scores at admission were independently associated with good outcomes and a decreased incidence of HAP. Comprehensive oral assessments are essential for acute stroke patients in clinical settings.
口腔护理对于预防心血管事件和肺炎至关重要。然而，很少有研究评估口腔状况或功能结果的多维评估与医院获得性肺炎（HAP）之间的关系。
回顾性分析连续的急性缺血性脑卒中（AIS）患者。我们评估了改良口腔评估等级（mOAG），并研究了其与改良Rankin 量表（mRS）评分 0-2（良好的卒中结局）和 HAP 的关系。mOAG 是为了评估 8 个类别（嘴唇、舌头、舌苔、唾液、口腔黏膜、牙龈、口腔保护和漱口）而开发的，评分范围为 0-3 分的 4 级评分。我们使用接收者操作特征（ROC）曲线分析来分析 mOAG 评分对预测卒中结局或 HAP 的有效性。
共分析了 247 例 AIS 患者。mOAG 预测不良结局的 ROC 曲线下面积为 0.821（临界值：7），预测 HAP 发生率的 ROC 曲线下面积为 0.783（临界值：8）。mOAG（增加 1 分）与不良卒中结局（优势比[OR]1.31，95%置信区间[CI]1.17-1.48，P<0.001）和 HAP（OR 1.21，95% CI 1.07-1.38，P=0.003）相关，校正基线临床特征（包括年龄和卒中严重程度）后。
入院时较低的 mOAG 评分与良好结局和 HAP 发生率降低独立相关。综合口腔评估对临床环境中的急性卒中患者至关重要。
