PDF(Pubmed)
Abstract：
BACKGROUND: Aspiration pneumonia has a high recurrence rate, and oral care by dentists has been found effective in preventing its onset; however, this has not been evaluated using prospective studies. Therefore, we conducted a prospective study to evaluate the effectiveness of professional oral care by dentists in reducing aspiration pneumonia recurrence in older adult patients.
METHODS: In this prospective cohort study, we evaluated a dental oral care intervention, using a historical control group (control group). It was conducted at a single-centre regional core hospital in Japan that serves a large number of patients aged older than 80 years. Patients who were hospitalised for aspiration pneumonia were included in this study. During the study period (1 April 2021 to 31 March 2022), the clinical group received weekly professional cleaning by a dentist and the control group received standard oral care by a nurse as usual from 1 April 2020 to 31 March 2021. The dentist oral care group received weekly professional oral care from a dentist and was followed prospectively for 1 year. A Kaplan-Meier analysis was used to evaluate the timing of recurrent aspiration pneumonia or death. A Cox proportional hazards model was used to obtain a hazard ratio and determine the 95% confidence intervals.
RESULTS: There were 91 participants in the clinical group and 94 in the control group. The mean age of participants was 85 years, and 75 (40.5%) were female. The recurrence rate was 27.5% in the clinical group and 44.7% in the control group (P = .005). Professional cleaning by a dentist reduced the risk of recurrence of aspiration pneumonia by approximately 50% (adjusted hazard ratio, 0.465; 95% confidence interval, 0.278-0.78).
CONCLUSIONS: Professional cleaning by a dentist was associated with a lower rate of aspiration pneumonia recurrence than nurse-provided conventional oral care.
METHODS: In this prospective cohort study, we evaluated a dental oral care intervention, using a historical control group (control group). It was conducted at a single-centre regional core hospital in Japan that serves a large number of patients aged older than 80 years. Patients who were hospitalised for aspiration pneumonia were included in this study. During the study period (1 April 2021 to 31 March 2022), the clinical group received weekly professional cleaning by a dentist and the control group received standard oral care by a nurse as usual from 1 April 2020 to 31 March 2021. The dentist oral care group received weekly professional oral care from a dentist and was followed prospectively for 1 year. A Kaplan-Meier analysis was used to evaluate the timing of recurrent aspiration pneumonia or death. A Cox proportional hazards model was used to obtain a hazard ratio and determine the 95% confidence intervals.
RESULTS: There were 91 participants in the clinical group and 94 in the control group. The mean age of participants was 85 years, and 75 (40.5%) were female. The recurrence rate was 27.5% in the clinical group and 44.7% in the control group (P = .005). Professional cleaning by a dentist reduced the risk of recurrence of aspiration pneumonia by approximately 50% (adjusted hazard ratio, 0.465; 95% confidence interval, 0.278-0.78).
CONCLUSIONS: Professional cleaning by a dentist was associated with a lower rate of aspiration pneumonia recurrence than nurse-provided conventional oral care.
摘要：
背景：吸入性肺炎复发率高，牙医的口腔护理可有效预防其发作；然而，这尚未通过前瞻性研究进行评估.因此,我们进行了一项前瞻性研究,以评估由牙医进行专业口腔护理在减少老年患者吸入性肺炎复发方面的效果.
方法：在这项前瞻性队列研究中，我们评估了牙科口腔护理干预，使用历史控制组（对照组）。它是在日本的一家单中心区域核心医院进行的，该医院为大量80岁以上的患者提供服务。本研究包括因吸入性肺炎住院的患者。在研究期间（2021年4月1日至2022年3月31日），从2020年4月1日至2021年3月31日,临床组接受牙医每周的专业清洁,对照组接受护士照常的标准口腔护理.牙医口腔护理组每周接受牙医的专业口腔护理，并前瞻性随访1年。Kaplan-Meier分析用于评估复发性吸入性肺炎或死亡的时机。使用Cox比例风险模型获得风险比并确定95%置信区间。
结果：临床组91例，对照组94例。参与者的平均年龄是85岁,75（40.5%）为女性。临床组复发率为27.5%,对照组为44.7%(P=0.005)。由牙医进行专业清洁可将吸入性肺炎复发的风险降低约50％（调整后的危险比，0.465；95%置信区间，0.278-0.78）。
结论：与护士提供的常规口腔护理相比，牙医的专业清洁与吸入性肺炎复发率较低相关。
方法：在这项前瞻性队列研究中，我们评估了牙科口腔护理干预，使用历史控制组（对照组）。它是在日本的一家单中心区域核心医院进行的，该医院为大量80岁以上的患者提供服务。本研究包括因吸入性肺炎住院的患者。在研究期间（2021年4月1日至2022年3月31日），从2020年4月1日至2021年3月31日,临床组接受牙医每周的专业清洁,对照组接受护士照常的标准口腔护理.牙医口腔护理组每周接受牙医的专业口腔护理，并前瞻性随访1年。Kaplan-Meier分析用于评估复发性吸入性肺炎或死亡的时机。使用Cox比例风险模型获得风险比并确定95%置信区间。
结果：临床组91例，对照组94例。参与者的平均年龄是85岁,75（40.5%）为女性。临床组复发率为27.5%,对照组为44.7%(P=0.005)。由牙医进行专业清洁可将吸入性肺炎复发的风险降低约50％（调整后的危险比，0.465；95%置信区间，0.278-0.78）。
结论：与护士提供的常规口腔护理相比，牙医的专业清洁与吸入性肺炎复发率较低相关。
