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使用修订后的口腔评估指南评估老年住院患者口腔健康与死亡率之间的关联:一项单中心观察性队列研究。

Using revised oral assessment guide to assess association between oral health and mortality in older inpatients: a single-center observational cohort study.

作者信息

Chen Kuan-Ying, Lin Shih-Yi, Weng Shuo-Chun, Lee Yu-Shan, Kuo Fu-Hsuan, Yeh Ya-Hui

机构信息

Department of Family Medicine, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, 407219, Taiwan, Republic of China.

Center for Geriatrics & Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China.

出版信息

BMC Oral Health. 2025 Jun 4;25(1):912. doi: 10.1186/s12903-025-06206-9.

Abstract

PURPOSE

For older adults, oral health represents a critical component of overall health; nevertheless, oral health is often neglected in older acute inpatients. We implemented a retrospective cohort study to assess oral health in older inpatients by using the revised oral assessment guide (ROAG) and examined the associations of oral health and mortality.

METHODS

The study was executed in a 35-bed geriatric ward. The study sample comprised patients aged 65 years or older, hospitalized with an acute condition. The oral health of the patients was assessed by trained nurses using revised oral assessment guide (ROAG). Data were collected during hospitalization from admission through discharge. Medical records were assessed to glean medical and demographic data. The mean follow-up time was 1.9 (SD 1) years. Mortality data were collected from a national population register. The age adjusted Charlson comorbidity index (ACCI) was employed to assess comorbidities. Cox regression was executed to identify associated factors.

RESULTS

360 patients were enrolled in the study. The mean ROAG score was 11.1 (SD 2.5), and 49.2% of the patients had a ROAG score greater or equal to 11. The oral problems that were most common were related to the teeth or dentures (74.2%), followed by problems related to the gums (32.8%). Significant associations between oral health problems and various patient characteristics were observed. The risks of overall mortality (HR = 1.67, P =.003) and 2-year mortality (HR = 1.72, P =.004) were significantly higher among patients with ROAG scores of ≥ 11 than among those with ROAG scores of < 11, after adjustment for potential confounders.

CONCLUSION

Among older acute inpatients, the prevalence of oral health problems was relatively high, and poor oral health was an independent mortality predictor. These findings highlight the importance of oral health care in older adults.

摘要

目的

对于老年人而言,口腔健康是整体健康的重要组成部分;然而,老年急性住院患者的口腔健康常常被忽视。我们开展了一项回顾性队列研究,以使用修订后的口腔评估指南(ROAG)评估老年住院患者的口腔健康状况,并研究口腔健康与死亡率之间的关联。

方法

该研究在一个拥有35张床位的老年病房中进行。研究样本包括65岁及以上因急性病住院的患者。由经过培训的护士使用修订后的口腔评估指南(ROAG)对患者的口腔健康状况进行评估。在患者住院期间,从入院到出院收集数据。评估病历以收集医疗和人口统计学数据。平均随访时间为1.9(标准差1)年。从国家人口登记处收集死亡率数据。采用年龄调整的查尔森合并症指数(ACCI)来评估合并症情况。进行Cox回归分析以确定相关因素。

结果

360名患者纳入该研究。ROAG评分的平均值为11.1(标准差2.5),49.2%的患者ROAG评分大于或等于11。最常见的口腔问题与牙齿或假牙有关(74.2%),其次是与牙龈有关的问题(32.8%)。观察到口腔健康问题与各种患者特征之间存在显著关联。在调整潜在混杂因素后,ROAG评分≥11的患者的全因死亡率风险(HR = 1.67,P = 0.003)和2年死亡率风险(HR = 1.72,P = 0.004)显著高于ROAG评分<11的患者。

结论

在老年急性住院患者中,口腔健康问题的患病率相对较高,口腔健康状况不佳是独立的死亡预测因素。这些发现凸显了老年人口腔保健的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c927/12139141/fd22d9621114/12903_2025_6206_Fig1_HTML.jpg

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