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牙科治疗对降低重症监护病房死亡率的贡献:一项为期6年的回顾性分析。

Contribution of dental treatment to reducing mortality in the ICUs: a 6-year retrospective analysis.

作者信息

Pains Marcos Barbosa, de Melo Nilce Santos, Leite André Ferreira, Mesquita Carla Ruffeil Moreira, de Souza Figueiredo Paulo Tadeu

机构信息

School of Public Health of the Federal District, Foundation for Education and Research in Health Sciences, Brasília - Distrito Federal, Brazil.

Department of Health of the Federal District, Brasília - Distrito Federal, Brazil.

出版信息

Sci Rep. 2025 May 25;15(1):18188. doi: 10.1038/s41598-024-84418-9.

DOI:10.1038/s41598-024-84418-9
PMID:40415019
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12104424/
Abstract

The aim of this study was to evaluate dental treatment outcomes and safety in the Intensive Care Unit (ICU). Data collected included the frequency of dental interventions, the incidence of ventilator-associated pneumonia (VAP), patient demographics, length of ICU stay, and mortality. In the statistical analysis, logistic regression models were utilized to explore associations between dental care and patient outcomes, calculating odds ratios for mortality outcomes, with adjustments for potential confounders. More than three interventions were associated with a lower risk of mortality in both crude (p < 0.0001) and adjusted analyses (p < 0.0001), suggesting a protective effect. Patients who received more frequent dental care demonstrated improved survival outcomes. VAP did not significantly increase mortality risk in this cohort (p = 0.3511). Dental procedures were not conclusively linked to a reduction in mortality; however, they were not associated with any important adverse effects, indicating that they are safe for ICU patients. The findings indicate that regular dental treatment in the ICU may be beneficial to patient survival and does not pose additional safety risks. While VAP did not independently predict mortality, receipt of comprehensive dental care was a protective factor.

摘要

本研究的目的是评估重症监护病房(ICU)中的牙科治疗效果和安全性。收集的数据包括牙科干预的频率、呼吸机相关性肺炎(VAP)的发生率、患者人口统计学信息、ICU住院时间和死亡率。在统计分析中,使用逻辑回归模型来探索牙科护理与患者预后之间的关联,计算死亡率结局的比值比,并对潜在混杂因素进行调整。在粗分析(p < 0.0001)和调整分析(p < 0.0001)中,超过三次干预均与较低的死亡风险相关,表明存在保护作用。接受更频繁牙科护理的患者生存结局得到改善。在该队列中,VAP并未显著增加死亡风险(p = 0.3511)。牙科治疗与死亡率降低之间没有确凿的联系;然而,它们与任何重要的不良反应均无关联,这表明它们对ICU患者来说是安全的。研究结果表明,在ICU中进行定期牙科治疗可能对患者生存有益,且不会带来额外的安全风险。虽然VAP并不能独立预测死亡率,但接受全面的牙科护理是一个保护因素。

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本文引用的文献

1
Professional oral health care prevents mouth-lung infection in long-term care homes: a systematic review.专业口腔保健可预防长期护理机构中的口鼻肺部感染:系统评价。
Can J Dent Hyg. 2023 Oct 1;57(3):180-190. eCollection 2023 Oct.
2
Demystifying the connection between periodontal disease and chronic kidney disease - An umbrella review.揭开牙周病与慢性肾脏病之间关联的神秘面纱——一篇伞式综述。
J Periodontal Res. 2023 Oct;58(5):874-892. doi: 10.1111/jre.13161. Epub 2023 Jul 21.
3
The oral microbiome in the pathophysiology of cardiovascular disease.口腔微生物组与心血管疾病的病理生理学。
Nat Rev Cardiol. 2023 Jun;20(6):386-403. doi: 10.1038/s41569-022-00825-3. Epub 2023 Jan 9.
4
Does the presence of oral health teams influence the incidence of ventilator-associated pneumonia and mortality of patients in intensive care units? Systematic review.口腔健康团队的存在是否会影响重症监护病房患者呼吸机相关性肺炎的发生率和死亡率?系统评价。
Spec Care Dentist. 2023 Jul-Aug;43(4):452-463. doi: 10.1111/scd.12785. Epub 2022 Oct 9.
5
The association between accessing dental services and nonventilator hospital-acquired pneumonia among 2019 Medicaid beneficiaries.2019 年医疗补助受益人群中,获得牙科服务与非呼吸机相关性医院获得性肺炎之间的关联。
Infect Control Hosp Epidemiol. 2023 Jun;44(6):959-961. doi: 10.1017/ice.2022.163. Epub 2022 Jul 11.
6
Dental care and hospital mortality in ICU patients.重症监护病房患者的牙科护理与医院死亡率
Am J Infect Control. 2022 Jun;50(6):714-715. doi: 10.1016/j.ajic.2022.02.020.
7
Association between periodontal care and hospitalization with acute myocardial infarction.牙周保健与急性心肌梗死住院的关系。
J Am Dent Assoc. 2022 Aug;153(8):776-786.e2. doi: 10.1016/j.adaj.2022.02.003. Epub 2022 Apr 20.
8
Impact of a dental care intervention on the hospital mortality of critically ill patients admitted to intensive care units: A quasi-experimental study.口腔护理干预对入住重症监护病房的危重症患者住院死亡率的影响:一项准实验研究。
Am J Infect Control. 2022 Oct;50(10):1156-1161. doi: 10.1016/j.ajic.2022.01.022. Epub 2022 Jan 30.
9
The impact of dental care intervention on ventilator-associate events: A Quasi-experimental study.口腔护理干预对呼吸机相关性事件的影响:一项准实验研究。
Am J Infect Control. 2022 Sep;50(9):1055-1059. doi: 10.1016/j.ajic.2021.11.026. Epub 2021 Dec 7.
10
Palliative care interventions in intensive care unit patients.重症监护病房患者的姑息治疗干预措施。
Intensive Care Med. 2021 Dec;47(12):1415-1425. doi: 10.1007/s00134-021-06544-6. Epub 2021 Oct 15.