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脑瘫患者肺炎与看牙就诊之间的关系:台湾一项基于全国登记系统的队列研究

The relationship between pneumonia and dental visits in patients with cerebral palsy: A nationwide registry-based cohort study in Taiwan.

作者信息

Liu Fu-Hsuan, Huang Jing-Yang, Chang Yu-Chao

机构信息

School of Dentistry, Chung Shan Medical University, Taichung, Taiwan.

Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.

出版信息

J Dent Sci. 2025 Jan;20(1):118-125. doi: 10.1016/j.jds.2024.09.019. Epub 2024 Oct 2.

Abstract

BACKGROUND/PURPOSE: In general, improving oral health can reduce the risk of pneumonia. The purpose of this retrospective cohort study was to investigate the risk of pneumonia between cerebral palsy (CP) cohort and non-CP cohort as well as the association of pneumonia with the number of dental visits in CP patients in Taiwan.

MATERIALS AND METHODS

We identified 10,544 patients who were diagnosed with CP between 2010 and 2019 from the Taiwan National Health Insurance Research Database. 63,264 individuals who had never been diagnosed with CP were captured and matched in a 6:1 ratio. Cox proportional hazard regression analysis was adopted to assess the hazard ratio (HR) of pneumonia between CP cohort and non-CP cohort.

RESULTS

Our findings demonstrated that CP cohort had 2.619-fold risk for pneumonia as compared with non-CP cohort after adjustment (95 % CI = 2.574-2.813,  < 0.0001). Cox regression analysis indicated that the CP group had significantly higher incidence risk of pneumonia (log rank  < 0.0001). Higher risks of pneumonia in CP patients were associated with younger age, and lower urbanization level. Some comorbidities as well as history of pneumonia had the higher aHR for pneumonia within 180 days prior to index date. In addition, there was a positive association with the more than two dental visits for the decrease 0.887-fold incidence of pneumonia in CP-cohort as compared with no dental visit (95 % CI: 0.799-0.984).

CONCLUSION

Taken together, CP patients had a higher risk of pneumonia. Dental visits are beneficial for preventing the risk of pneumonia in CP patients. The patients with CP should receive regular dental checkup.

摘要

背景/目的:一般来说,改善口腔健康可降低肺炎风险。这项回顾性队列研究的目的是调查台湾脑瘫(CP)队列和非CP队列之间的肺炎风险,以及CP患者肺炎与牙科就诊次数的关联。

材料与方法

我们从台湾国民健康保险研究数据库中确定了2010年至2019年间被诊断为CP的10544例患者。选取63264例从未被诊断为CP的个体并按6:1的比例进行匹配。采用Cox比例风险回归分析评估CP队列和非CP队列之间肺炎的风险比(HR)。

结果

我们的研究结果表明,调整后CP队列患肺炎的风险是非CP队列的2.619倍(95%CI = 2.574 - 2.813,P < 0.0001)。Cox回归分析表明CP组肺炎的发病风险显著更高(对数秩检验P < 0.0001)。CP患者患肺炎的较高风险与年龄较小和城市化水平较低有关。一些合并症以及肺炎病史在索引日期前180天内患肺炎的调整后风险比更高。此外,与未进行牙科就诊相比,CP队列中进行超过两次牙科就诊与肺炎发病率降低0.887倍呈正相关(95%CI:0.799 - 0.984)。

结论

综上所述,CP患者患肺炎的风险更高。牙科就诊有利于预防CP患者患肺炎的风险。CP患者应接受定期牙科检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7773/11762931/57a5b80e2fbe/gr1.jpg

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