Effects of perioperative oral care on prevention of postoperative pneumonia after lung resection: Multicenter retrospective study with propensity score matching analysis
Effects of perioperative oral care on prevention of postoperative pneumonia after lung resection: Multicenter retrospective study with propensity score matching analysis
复制标题
DOI：
10.1016/j.surg.2018.11.020
复制
发表时间：
2019-05-01
期刊：
影响因子：
3.8
通讯作者：
Komori, Takahide
中科院分区：
文献类型：
--
作者：
Iwata, Eiji;Hasegawa, Takumi;Komori, Takahide
背景：术后肺炎是癌症患者肺切除术后可能发生的致命并发症。有报道表明，围手术期口腔护理可降低食管癌术后肺炎的发生率；然而，没有数据表明围手术期口腔护理的缺乏可能是肺切除术后肺炎的危险因素。为了探讨口腔护理预防效果与术后肺炎之间的关系，我们对行肺切除术的肺癌患者进行了一项多中心、回顾性研究。方法：2014年1月至2016年12月，在纳入研究的6家医院中的1家，共721例患者行肺切除术。721例患者中，280例（38.8%）患者接受了围手术期口腔护理，其余441例（61.2%）患者未接受任何口腔护理。进行倾向评分匹配，以尽量减少与口腔护理组和对照组之间回顾性数据比较相关的选择偏差。结果：721例患者中有54例（7.5%）发生术后肺炎，其中口腔护理组280例患者中有13例（4.6%）发生肺炎，对照组441例患者中有41例（9.3%）发生肺炎（P = 0.02）。在倾向评分分析中，口腔护理干预与术后肺炎的发生率也有显著差异（P = 0.002）。结论：围手术期口腔护理是减少肺切除术患者术后肺炎发生的有效方法。(C) 2018爱思唯尔公司版权所有。
Background: Postoperative pneumonia can be a fatal complication that may occur after lung resection in cancer patients. Some reports have shown that the incidence of postoperative pneumonia is decreased after esophageal surgery by perioperative oral care; however, there exist no data to suggest that a lack of perioperative oral care can be a risk factor for postoperative pneumonia after lung resection. To investigate the association between the preventive effect of oral care and postoperative pneumonia, we conducted a multicenter, retrospective study of lung cancer patients who underwent lung resection.Methods: Between January 2014 and December 2016, a total of 721 patients underwent lung resections at 1 of the 6 hospitals included in our study. Among 721 patients, 280 (38.8%) received perioperative oral care, and the remaining 441 (61.2%) did not receive any such care. Propensity score matching was performed to minimize selection biases associated with the comparison of retrospective data between the oral care and control groups.Results: Of the 721 patients, 54 (7.5%) experienced postoperative pneumonia involving 13 of the 280 patients (4.6%) in the oral care group and 41 of the 441 patients (9.3%) in the control group (P =.02). On propensity score analysis, a significant difference was also found between oral care intervention and incidence of postoperative pneumonia (P =.002).Conclusion: Our results suggest that perioperative oral care is an effective method to decrease the occurrence of postoperative pneumonia in patients who have undergone lung resection. (C) 2018 Elsevier Inc. All rights reserved.