Matsunaga Kazuyuki, Yoshida-Tsuboi Ayaka, Inohara Ken, Yoshida Yasuko, Nakahama Kanako, Sasaki Kazuki, Souda Fumie, Terasawa Yuka, Shimoe Yutaka, Takeuchi-Hatanaka Kazu, Yamamoto Tadashi, Omori Kazuhiro, Kohriyama Tatsuo, Takashiba Shogo
Brain Attack Center, Ota Memorial Hospital, Fukuyama, Japan.
Department of Periodontics and Endodontics, Division of Dentistry, Okayama University Hospital, Okayama, Japan.
Geriatr Gerontol Int. 2025 Jan;25(1):48-53. doi: 10.1111/ggi.15035. Epub 2024 Dec 9.
This study aimed to evaluate the effectiveness of oral health assessment tools in facilitating oral health care interventions by dental care providers for acute stroke patients within 48 h of admission, following a reform of the nursing system.
Data were gathered from a retrospective cohort study conducted at a stroke center, comparing 10 months before and after the implementation of the reformed system, with a 2-month interval. Parameters assessed included stroke type, severity measured using the National Institutes of Health Stroke Scale, stroke history, stroke-related factors, number of teeth, hospitalization cost and duration, occurrence of fever and pneumonia, stroke treatment, days from admission to dental intervention, and intervention frequency.
Implementation of the new system significantly reduced the time before dental intervention (P < 0.001), increased the frequency of interventions (P < 0.001), and allowed for the management of more severe cases (P = 0.007). However, there was a slight increase in the occurrence of fevers and the days of fever (P = 0.039 and P = 0.015, respectively). Multiple regression analysis showed that fever days were positively correlated with stroke severity and the number of days from admission to dental intervention (P < 0.001 and P = 0.013, respectively). Even after propensity score matching adjusting for stroke severity, these associations persisted. Additional multiple regression analysis was performed after this, but fever days were positively correlated with stroke severity and sex (P < 0.001 and P = 0.008, respectively), as well as with the presence of other factors affecting the occurrence of fever.
Although the frequency and duration of fevers increased slightly, this approach, incorporating oral health assessment tools, made it possible to provide early dental intervention, particularly for patients with severe strokes. Geriatr Gerontol Int 2025; 25: 48-53.
本研究旨在评估口腔健康评估工具在护理系统改革后,对急性医护护理人员对急性中风患者入院48小时内实施口腔保健干预措施中的有效性。
数据来自在一家中风中心进行的回顾性队列研究,比较改革后的系统实施前后10个月,间隔为2个月。评估的参数包括中风类型、使用美国国立卫生研究院中风量表测量的严重程度、中风病史、中风相关因素、牙齿数量、住院费用和时长、发热和肺炎的发生情况、中风治疗、从入院到牙科干预的天数以及干预频率。
新系统的实施显著缩短了牙科干预前的时间(P<0.001),增加了干预频率(P<0.001),并能够处理更严重的病例(P=0.007)。然而,发热的发生率和发热天数略有增加(分别为P=0.039和P=0.015)。多元回归分析表明,发热天数与中风严重程度以及从入院到牙科干预的天数呈正相关(分别为P<0.001和P=0.013)。即使在根据中风严重程度进行倾向得分匹配调整后,这些关联仍然存在。在此之后进行了额外的多元回归分析,但发热天数与中风严重程度和性别呈正相关(分别为P<0.001和P=0.008),以及与其他影响发热发生的因素有关。
尽管发热的频率和时长略有增加,但这种纳入口腔健康评估工具的方法使得早期牙科干预成为可能,特别是对于严重中风患者。《老年医学与老年病学国际杂志》2025年;25:48 - 53。