Premium
Oral health and ventilator‐associated pneumonia among critically ill patients: a prospective study
Author(s) -
Saensom D,
Merchant AT,
Waraaswapati N,
Ruaisungnoen W,
Pitiphat W
Publication year - 2016
Publication title -
oral diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.953
H-Index - 87
eISSN - 1601-0825
pISSN - 1354-523X
DOI - 10.1111/odi.12535
Subject(s) - medicine , ventilator associated pneumonia , prospective cohort study , pneumonia , oral hygiene , intubation , incidence (geometry) , hazard ratio , mechanical ventilation , proportional hazards model , cohort study , confidence interval , surgery , dentistry , physics , optics
Objective To evaluate the association between oral health and ventilator‐associated pneumonia ( VAP ) among critically ill patients. Methods A prospective cohort study was conducted among 162 critically ill patients newly intubated and treated with mechanical ventilator in one tertiary hospital in Thailand. Oral health status was assessed using Oral Health Assessment Tool ( OHAT ), Plaque Index ( PI ), and number of teeth. VAP , defined as Clinical Pulmonary Infection Score >6, was assessed on Day 4 after intubation. Hazard ratios and 95% confidence intervals ( CI s) were calculated using Cox proportional hazards regression adjusted for confounders. Results Critically ill patients had deteriorating oral health status after intubation. Early‐onset VAP developed in 69 patients (42.6%), with VAP incidence of 117 episodes per 1000 ventilator‐days. Moderately unhealthy and unhealthy oral conditions based on OHAT scores were associated with a 2.92‐fold (95% CI : 1.26–6.74) and 3.22‐fold (95% CI : 1.34–7.76) increased risk of VAP . Patients with moderate‐to‐very poor oral hygiene assessed by PI had increased VAP risk of 1.66‐folds (95% CI : 1.001–2.75). The number of teeth was not associated with VAP development. Conclusions There is a strong association between poor oral health and increased risk for early‐onset VAP . Routine oral care possibly prevents VAP development among critically ill patients treated with mechanical ventilator.