Journal of the American Geriatrics Society · 2001
Aspiration pneumonia: dental and oral risk factors in an older veteran population.
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Terpenning M S, Taylor G W, Lopatin D E, Kerr C K, Dominguez B L, Loesche W J
Аннотация
OBJECTIVES: To investigate the importance of medical and dental factors in aspiration pneumonia in an older veteran population.
DESIGN: Prospective enrollment of subjects with retrospective analysis of data.
SETTING: Department of Veterans Affairs outpatient clinic, inpatient ward, and nursing home.
PARTICIPANTS: 358 veterans age 55 and older; 50 subjects with aspiration pneumonia.
MEASUREMENTS: Demographic and medical data; functional status; health-related behaviors; dental care utilization; personal oral hygiene; comprehensive dental examination; salivary assays including IgA antibodies; and cultures of saliva, throat, and dental plaques.
RESULTS: Two logistic regression models produced estimates of significant risk factors. One model using dentate patients included: requiring help with feeding (odds ratio (OR) = 13.9), chronic obstructive pulmonary disease (COPD) (OR = 4.7), diabetes mellitus (OR = 3.5), number of decayed teeth (OR = 1.2), number of functional dental units (OR = 1.2), presence of important organisms for decay, Streptococcus sobrinus in saliva (OR = 6.2), and periodontal disease, Porphyromonous gingivalis in dental plaque (OR = 4.2), and Staphylococcus aureus presence in saliva (OR = 7.4). The second model, containing both dentate and edentulous patients included: requiring help with feeding (OR = 4.7), COPD (OR = 2.5), diabetes mellitus (OR = 1.7), and presence of S. aureus in saliva (OR = 8.3).
CONCLUSION: This study supports the significance of oral and dental factors while controlling for established medical risk factors in aspiration pneumonia incidence.
DESIGN: Prospective enrollment of subjects with retrospective analysis of data.
SETTING: Department of Veterans Affairs outpatient clinic, inpatient ward, and nursing home.
PARTICIPANTS: 358 veterans age 55 and older; 50 subjects with aspiration pneumonia.
MEASUREMENTS: Demographic and medical data; functional status; health-related behaviors; dental care utilization; personal oral hygiene; comprehensive dental examination; salivary assays including IgA antibodies; and cultures of saliva, throat, and dental plaques.
RESULTS: Two logistic regression models produced estimates of significant risk factors. One model using dentate patients included: requiring help with feeding (odds ratio (OR) = 13.9), chronic obstructive pulmonary disease (COPD) (OR = 4.7), diabetes mellitus (OR = 3.5), number of decayed teeth (OR = 1.2), number of functional dental units (OR = 1.2), presence of important organisms for decay, Streptococcus sobrinus in saliva (OR = 6.2), and periodontal disease, Porphyromonous gingivalis in dental plaque (OR = 4.2), and Staphylococcus aureus presence in saliva (OR = 7.4). The second model, containing both dentate and edentulous patients included: requiring help with feeding (OR = 4.7), COPD (OR = 2.5), diabetes mellitus (OR = 1.7), and presence of S. aureus in saliva (OR = 8.3).
CONCLUSION: This study supports the significance of oral and dental factors while controlling for established medical risk factors in aspiration pneumonia incidence.
Предметные рубрики MeSH
Activities of Daily LivingAge DistributionAge FactorsAgedAged, 80 and overDental CariesDental PlaqueDiabetes ComplicationsGeriatric AssessmentHumansIncidenceLogistic ModelsLung Diseases, ObstructiveMichiganMouth, EdentulousOral HealthPneumonia, AspirationRisk FactorsSalivaStaphylococcal InfectionsStaphylococcus aureusStreptococcal InfectionsStreptococcus sobrinusStrokeVeterans