Pilot study for risk assessment of aspiration pneumonia based on oral bacteria levels and serum biomarkers
Pilot study for risk assessment of aspiration pneumonia based on oral bacteria levels and serum biomarkers
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DOI：
10.1186/s12879-019-4327-2
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发表时间：
2019-09-02
影响因子：
3.7
通讯作者：
Takizawa, Hajime
中科院分区：
文献类型：
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作者：
Nishizawa, Tomotaka;Niikura, Yuichi;Takizawa, Hajime
背景 吸入性肺炎是老年患者的一个严重问题；它是由许多危险因素引起的，包括吞咽困难、口腔卫生不良、营养不良和镇静药物。本研究的目的是定义一种方便的程序来客观评估临床环境中吸入性肺炎的风险。方法 这项前瞻性研究包括吸入性肺炎（AP）组、社区获得性肺炎（CAP）组和对照组（Con）组（因肺癌化疗住院的患者）。我们使用口腔健康评估工具（OHAT）来评估口腔卫生，并评估体能状态、体重指数、血清白蛋白水平、血浆中 P 物质值和口腔细菌计数。结果 与 CAP 组和对照组相比，通过 OHAT 评估的吸入性肺炎组口腔健康状况显着受损（分别为 5.13 +/- 0.18、4.40 +/- 0.26、3.90 +/- 0.22；p < 0.05）。吸入性肺炎组口腔细菌计数（7.20±0.11）显着高于CAP组（6.89±0.12），与OHAT评分一致。通过口腔护理，口腔细菌数量显着减少。结论 OHAT 和口腔细菌计数可以作为评估吸入性肺炎高危患者采取口腔护理和其他预防措施的要求的工具。
Background Aspiration pneumonia is a serious problem among elderly patients; it is caused by many risk factors including dysphagia, poor oral hygiene, malnutrition, and sedative medications. The aim of this study was to define a convenient procedure to objectively evaluate the risk of aspiration pneumonia in the clinical setting. Methods This prospective study included an aspiration pneumonia (AP) group, a community-acquired pneumonia (CAP) group, and a control (Con) group (patients hospitalized for lung cancer chemotherapy). We used the Oral Health Assessment Tool (OHAT), which assesses oral hygiene, and evaluated performance status, body mass index, serum albumin levels, substance P values in plasma, and oral bacterial counts. Results The oral health as assessed by the OHAT of the aspiration pneumonia group was significantly impaired compared with that of the CAP group and the control (5.13 +/- 0.18, 4.40 +/- 0.26, 3.90 +/- 0.22, respectively; p < 0.05). The oral bacterial count in the aspiration pneumonia group (7.20 +/- 0.11) was significantly higher than that in the CAP group (6.89 +/- 0.12), consistent with the OHAT scores. Oral bacterial count was significantly reduced by oral care. Conclusions OHAT and oral bacterial counts can be a tool to assess the requirement of taking oral care and other preventive procedures in patients at high risk of aspiration pneumonia.