Modification of the risk of mortality from pneumonia with oral hygiene care.
OBJECTIVE
To investigate the associations between the assignment of an oral hygiene aide staff member and risk factors for mortality from pneumonia in a nursing home and to test the hypothesis that this care would affect the incidence of mortality from pneumonia.


METHODS
Electronic medical records.


METHODS
Nursing home.


METHODS
One hundred forty-three residents of a Veterans Affairs Medical Center (VAMC) nursing home.


METHODS
The electronic medical records of 143 residents of a VAMC nursing home were analyzed for risk factors for pneumonia. A certified nursing assistant had been assigned to provide oral hygiene care for residents on two of four nursing home wards. Researchers performed a longitudinal analysis of resident's medical records to investigate the association between the assignment of an oral hygiene aide with the risk of mortality from pneumonia.


RESULTS
Initially, the group that received oral care, an older and less functionally able group, showed approximately the same incidence of mortality from pneumonia as the group that did not receive oral care, but when the data were adjusted for the risk factors found to be significant for mortality from pneumonia, the odds of dying from pneumonia in the group that did not receive oral care was more than three times that of the group that did receive oral care (odds ratio=3.57, P=.03). Modified risk factors included age, functionality, cognitive function, and clinical concern about aspiration pneumonia.


CONCLUSIONS
Oral hygiene nursing aide intervention may be an efficient risk factor modifier of mortality from nursing home-associated pneumonia.
Bassim
Carol W
CW
Dental Service, Washington, DC, Veterans Affairs Medical Center, Washington, District of Columbia, USA. bassimc@mail.nih.gov
Gibson
Gretchen
G
Ward
Timothy
T
Paphides
Brian M
BM
Denucci
Donald J
DJ
D000203:Activities of Daily Living / Q000145:classification; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000401:mortality; D015897:Comorbidity; D005260:Female; D005431:Florida; D006801:Humans; D015994:Incidence; D008297:Male; D009735:Nursing Homes; D009911:Oral Hygiene Index; D011015:Pneumonia, Aspiration / Q000401:mortality; D018410:Pneumonia, Bacterial / Q000401:mortality*; D012307:Risk Factors