Yang Xiaohua, Lu Yingqiong, Chen Huijuan, Wei Juan, He Juan, Zhang Juan, Hu Tingting, Wang Qing, Tao Xi
Department of Neurology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China.
School of Rehabilitation Sciences, Southern Medical University, Guangzhou, Guangdong Province, China.
Medicine (Baltimore). 2025 Mar 7;104(10):e41758. doi: 10.1097/MD.0000000000041758.
Stroke-associated pneumonia (SAP) is a major stroke complication. Oral microorganisms are important contributors to SAP. Here, we aimed to investigate whether oral hygiene is associated with early SAP (<72 h of stroke onset) in patients with ischemic stroke. We performed an observational study of 331 patients with acute ischemic stroke from 2 medical centers. A series of assessments were performed to evaluate the neurological status, Beck Oral Assessment Scale (BOAS), and habits of oral hygiene. Univariate and binary logistic regression analyses were conducted to identify the risk factors for early SAP. Potentially relevant factors for oral hygiene in patients with early SAP and general ischemic stroke were also analyzed. Older age, higher prevalence of coronary heart disease, dysphagia and feeding with stomach tube, shorter course of disease as well as severe neurological impairments (such as National Institutes of Health Stroke Scale and Mini-Mental State Examination) were occurred in patients with early SAP (vs non-SAP, all P < .05). After adjusting for confounders, the analysis showed that BOAS score (odds ratio [OR] = 1.972, 95% confidence interval [CI] [1.479, 2.630], P < .001) and National Institutes of Health Stroke Scale (OR = 1.322, 95% CI [1.211, 1.443], P < .001) were independent risk factors for early SAP (OR = 1.678, P = .001). The correlation between BOAS scores and potential variables showed sex-dependent differences in patients with early SAP (all P < .05). The severity of neurologic impairment, age, and number of dental caries may be factors that influence abnormal BOAS scores (vs normal BOAS scores, all P < .05). Abnormal oral hygiene was an independently associated factor in the assessment of early SAP. Emphasis on the relevant influences on oral health may be a nursing strategy for reducing the occurrence of SAP.
卒中相关性肺炎（SAP）是一种主要的卒中并发症。口腔微生物是SAP的重要促成因素。在此，我们旨在调查口腔卫生状况是否与缺血性卒中患者的早期SAP（卒中发作<72小时）相关。我们对来自2个医疗中心的331例急性缺血性卒中患者进行了一项观察性研究。进行了一系列评估以评估神经功能状态、贝克口腔评估量表（BOAS）和口腔卫生习惯。进行单因素和二元逻辑回归分析以确定早期SAP的危险因素。还分析了早期SAP患者和一般缺血性卒中患者口腔卫生的潜在相关因素。早期SAP患者（与非SAP患者相比，所有P<0.05）出现年龄较大、冠心病患病率较高、吞咽困难和鼻饲、病程较短以及严重神经功能障碍（如美国国立卫生研究院卒中量表和简易精神状态检查表）。在调整混杂因素后，分析表明BOAS评分（比值比[OR]=1.972，95%置信区间[CI][1.479，2.630]，P<0.001）和美国国立卫生研究院卒中量表（OR=1.322，95%CI[1.211，1.443]，P<0.001）是早期SAP的独立危险因素（OR=1.678，P=0.001）。早期SAP患者中，BOAS评分与潜在变量之间的相关性存在性别差异（所有P<0.05）。神经功能障碍的严重程度、年龄和龋齿数量可能是影响BOAS评分异常的因素（与正常BOAS评分相比，所有P<0.05）。口腔卫生异常是早期SAP评估中的一个独立相关因素。重视对口腔健康的相关影响可能是减少SAP发生的一种护理策略。
