Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan.
Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan; Division of Occupational Medicine, Department of Emergency, Taichung Veterans General Hospital, Taichung, Taiwan; Geriatrics and Gerontology Research Center, College of Medicine, National Chung Hsing University, Taichung, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
J Nutr Health Aging. 2024 Nov;28(11):100385. doi: 10.1016/j.jnha.2024.100385. Epub 2024 Oct 29.
OBJECTIVES: To evaluate the relationship between oral health and geriatric disorders, as well as its role in clinical outcomes among acutely admitted older patients. DESIGN: A retrospective observational study was conducted. SETTING: The study was conducted at a medical center in central Taiwan. PARTICIPANTS: A total of 1,141 patients (651 males and 490 females), aged 65 years or older, were admitted due to acute illness with geriatric syndromes from October 1, 2018, to March 31, 2023. MEASUREMENTS: A comprehensive geriatric assessment (CGA) was conducted, covering the comorbidity index, cognitive status, mood, physical function, nutritional status, mobility, health-related quality of life, frailty, and oral health condition. Oral health was evaluated using a bedside oral examination with scores ranging from 8 to 24, where scores of 8-10 indicated normal oral health, 11-14 indicated moderate impairment, and 15-24 indicated severe impairment. The primary outcome observed was in-hospital mortality. RESULTS: Among the participants, 40.5% experienced cognitive impairment, 24.8% exhibited depressive symptoms, 69.4% had low hand grip strength, 36.5% demonstrated low performance in mobility, and 78.9% were at risk of malnutrition. Severe impairment of oral health was found in 18.8% of the participants, while frailty was observed in 85.1%. Stratification of oral health severity revealed differences in various CGA parameters, including comorbidity, polypharmacy, cognitive impairment, depressive mood, physical activity, mobility, nutritional status, and quality of life, as well as clinical outcomes such as length of stay and in-hospital mortality between the groups. In univariable analysis, age, gender, frailty, oral health impairment, comorbidity index, nutritional status, and cognitive and physical functions were all significantly associated with in-hospital mortality. After adjusting for significant factors, severe oral health impairment remained significantly associated with mortality. CONCLUSION: In acutely admitted older patients, oral health was associated with geriatric disorders and was linked to in-hospital mortality. Early intervention in oral health may be necessary to improve outcomes.
目的：评估口腔健康与老年疾病的关系，以及其在急性入住老年患者临床结局中的作用。
设计：回顾性观察性研究。
地点：本研究在台湾中部的一家医疗中心进行。
参与者：共有 1141 名年龄在 65 岁或以上、因老年综合征急性入院的患者（651 名男性和 490 名女性），他们于 2018 年 10 月 1 日至 2023 年 3 月 31 日入院。
测量方法：进行全面老年评估（CGA），包括合并症指数、认知状态、情绪、身体功能、营养状况、活动能力、健康相关生活质量、衰弱和口腔健康状况。口腔健康采用床边口腔检查进行评估，评分范围为 8-24 分，8-10 分为口腔健康正常，11-14 分为中度损害，15-24 分为重度损害。观察的主要结局为院内死亡率。
结果：参与者中 40.5%存在认知障碍，24.8%存在抑郁症状，69.4%握力低，36.5%活动能力差，78.9%有营养不良风险。18.8%的参与者口腔健康严重受损，85.1%的参与者衰弱。口腔健康严重程度的分层显示，在各种 CGA 参数（包括合并症、多药治疗、认知障碍、抑郁情绪、身体活动、活动能力、营养状况和生活质量）以及组间住院时间和院内死亡率等临床结局方面存在差异。单变量分析显示，年龄、性别、衰弱、口腔健康损害、合并症指数、营养状况以及认知和身体功能均与院内死亡率显著相关。在校正显著因素后，严重的口腔健康损害仍与死亡率显著相关。
结论：在急性入住的老年患者中，口腔健康与老年疾病有关，并与院内死亡率相关。早期干预口腔健康可能有助于改善结局。
J Nutr Health Aging. 2024-11
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