Oral health and ventilator-associated pneumonia among critically ill patients: a prospective study

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 Tha...

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Published in:	Oral diseases Vol. 22; no. 7; pp. 709 - 714
Main Authors:	Saensom, D, Merchant, AT, Wara-aswapati, N, Ruaisungnoen, W, Pitiphat, W
Format:	Journal Article
Language:	English
Published:	Denmark Blackwell Publishing Ltd 01-10-2016 Wiley Subscription Services, Inc
Subjects:	Adult Cohort Studies Critical Illness critically ill patients Dentistry Female Health risk assessment Humans Intubation Male Oral Health Oral hygiene Pneumonia Pneumonia, Ventilator-Associated - etiology Prospective Studies ventilator-associated pneumonia Ventilators critically ill patients oral health ventilator-associated pneumonia
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Summary:	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 (CIs) 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.
Bibliography:	ark:/67375/WNG-ZK31784G-M ArticleID:ODI12535 istex:795BF08B1D63729F883F89528328CE5FB8187B34 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1354-523X 1601-0825
DOI:	10.1111/odi.12535