重症监护病房患者口腔念珠菌病和唾液分泌减少的相关因素：一项前瞻性队列研究。

Factors associated with oral candidosis and hyposalivation in intensive care unit patients: a prospective cohort study.

作者信息

da Silva Sarah Emily Melo, Fernandes Romana Rênery, da Silva Maria Eduarda Marques, Duarte Héverton Oliveira, da Câmara Rosângela Oliveira, de Sousa Lopes Maria Luiza Diniz, de Aquino Martins Ana Rafaela Luz, Da Silveira Éricka Janine Dantas

机构信息

Department of Dentistry, Federal University of Rio Grande do Norte - UFRN, Av. Senador Salgado Filho 1787, 59056-000, Natal, Rio Grande do Norte, Brazil.

General João Machado Hospital, Natal, RN, Brazil.

出版信息

Clin Oral Investig. 2025 Jul 29;29(8):392. doi: 10.1007/s00784-025-06465-4.

DOI:10.1007/s00784-025-06465-4

PMID:40728670

Abstract

OBJECTIVE

To separately investigate the occurrence of oral candidosis and hyposalivation in Intensive Care Unit (ICU) patients and identify contributing factors.

METHODS

A prospective cohort study was conducted with 100 ICU patients in a hospital in northeastern Brazil. Detailed intraoral examinations were performed daily by calibrated dentists, and sociodemographic and general health-related data were extracted from medical records. Pearson's Chi-square or Fisher's exact test assessed variable associations. Survival analysis estimated the onset time of oral candidosis and hyposalivation and their associations with risk factors.

RESULTS

Among the 100 patients, 65% developed hyposalivation, and 11% presented oral candidiasis. The median age was 64 years, with a predominance of males. No significant associations were found between oral candidiasis and demographic or clinical variables. Hyposalivation was significantly linked to underlying renal disease, anemia, and the use of medications such as antibiotics, corticosteroids, anticholinergics, and bronchodilators. Co-occurrence of candidosis and hyposalivation were observed in 7 patients. There was no statistically significant association of the development of oral candidosis or hyposalivation with other oral changes. Anticoagulant use was significantly associated with a higher oral candidiasis-free survival rate. Underlying renal disease, antibiotic treatment, and orotracheal intubation were significantly associated with a reduced survival rate free from hyposalivation.

CONCLUSIONS

Hyposalivation was highly prevalent and may be linked to the development of other oral conditions, such as oral candidosis. Understanding factors that contribute to hyposalivation and oral candidosis is essential for improving ICU healthcare and enhancing patient recovery.

CLINICAL RELEVANCE

Early identification and management of hyposalivation should be prioritized in ICU protocols to enhance patient recovery and oral health care.

摘要

目的

分别调查重症监护病房（ICU）患者口腔念珠菌病和唾液分泌减少的发生情况，并确定相关因素。

方法

在巴西东北部一家医院对100名ICU患者进行了一项前瞻性队列研究。由经过校准的牙医每天进行详细的口腔检查，并从病历中提取社会人口统计学和一般健康相关数据。采用Pearson卡方检验或Fisher精确检验评估变量之间的关联。生存分析估计口腔念珠菌病和唾液分泌减少的发病时间及其与危险因素的关联。

结果

100名患者中，65%出现唾液分泌减少，11%出现口腔念珠菌病。中位年龄为64岁，男性占多数。未发现口腔念珠菌病与人口统计学或临床变量之间存在显著关联。唾液分泌减少与潜在的肾脏疾病、贫血以及使用抗生素、皮质类固醇、抗胆碱能药物和支气管扩张剂等药物显著相关。7名患者同时出现念珠菌病和唾液分泌减少。口腔念珠菌病或唾液分泌减少的发生与其他口腔变化之间无统计学显著关联。使用抗凝剂与较高的无口腔念珠菌病生存率显著相关。潜在的肾脏疾病、抗生素治疗和经口气管插管与无唾液分泌减少的生存率降低显著相关。