title: Oral care may reduce pneumonia in the tube-fed elderly: a preliminary study.
abstract: Pneumonia is one of the most important diseases in terms of mortality in the elderly. In particular, bedridden patients who are forbidden oral ingestion during enteral nutrition may have a poor outcome resulting from a respiratory infection. Oral hygiene can play a positive role in preventing aspiration pneumonia in the elderly. The aim of this study was to investigate the effectiveness of oral hygiene for bedridden and tube-fed patients at an increased risk of pneumonia. This retrospective study was conducted from July 2011 to June 2013 on a long-term-care hospital unit. The oral care protocol (OCP) intervention commenced in July 2012, during the study period. The subjects of this study were 63 elderly patients with a mean age of 81.7 years. Thirty-one patients were enrolled in the OCP intervention group, and the mean observation length was 130.4 days; the mean observation length for the 32 patients in the control group was 128.4 days. The incidence of pneumonia and the numbers of days with a recorded fever, antibiotics administration, blood tests, and radiological examinations were reduced from 1.20 to 0.45, 24.57 to 17.48, 25.52 to 10.12, 10.91 to 6.54, and 6.33 to 3.09 %, respectively. These reductions were significantly less in the OCP intervention group. In conclusion, the results of the present study suggest that daily oral care for tube-fed patients who do not receive nutrition by mouth reduced the incidence of pneumonia. In addition to patients consuming food by mouth, all tube-fed patients require dedicated oral care to maintain healthy oral conditions.
authors.affiliation: Department of Internal Medicine, Tamana Regional Health Medical Center, 2172 Tamana, Tamana, Kumamoto, 865-0005, Japan, maeda4work@tng.bbiq.jp.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Maeda
authors.forename: Junji
authors.initials: J
authors.lastname: Akagi
mesh_terms: D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D015992:Body Mass Index; D002710:Chlorhexidine / Q000627:therapeutic use; D065187:Controlled Before-After Studies; D004338:Drug Combinations; D004750:Enteral Nutrition / Q000295:instrumentation*; D005260:Female; D005334:Fever / Q000517:prevention & control; D005949:Glucose Oxidase / Q000627:therapeutic use; D006403:Hematologic Tests / Q000706:statistics & numerical data; D006801:Humans; D007103:Immobilization; D007784:Lactoperoxidase / Q000627:therapeutic use; D008134:Long-Term Care; D008297:Male; D008405:Massage; D009113:Muramidase / Q000627:therapeutic use; D009910:Oral Hygiene; D011015:Pneumonia, Aspiration / Q000517:prevention & control*; D013902:Radiography, Thoracic / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012469:Salivary Glands / Q000502:physiology; D012709:Serum Albumin / Q000032:analysis; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data; D014099:Toothbrushing / Q000379:methods
chemical_list: D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; C111669:Biotene; D004338:Drug Combinations; D012709:Serum Albumin; D005949:Glucose Oxidase; D007784:Lactoperoxidase; D009113:Muramidase; D002710:Chlorhexidine