Abstract
BackgroundAspiration pneumonia is a serious problem among elderly patients; it is caused by many risk factors including dysphagia, poor oral hygiene, malnutrition, and sedative medications. The aim of this study was to define a convenient procedure to objectively evaluate the risk of aspiration pneumonia in the clinical setting.MethodsThis prospective study included an aspiration pneumonia (AP) group, a community-acquired pneumonia (CAP) group, and a control (Con) group (patients hospitalized for lung cancer chemotherapy). We used the Oral Health Assessment Tool (OHAT), which assesses oral hygiene, and evaluated performance status, body mass index, serum albumin levels, substance P values in plasma, and oral bacterial counts.ResultsThe oral health as assessed by the OHAT of the aspiration pneumonia group was significantly impaired compared with that of the CAP group and the control (5.13 ± 0.18, 4.40 ± 0.26, 3.90 ± 0.22, respectively; p < 0.05). The oral bacterial count in the aspiration pneumonia group (7.20 ± 0.11) was significantly higher than that in the CAP group (6.89 ± 0.12), consistent with the OHAT scores. Oral bacterial count was significantly reduced by oral care.ConclusionsOHAT and oral bacterial counts can be a tool to assess the requirement of taking oral care and other preventive procedures in patients at high risk of aspiration pneumonia.
Highlights
Aspiration pneumonia is a serious problem among elderly patients; it is caused by many risk factors including dysphagia, poor oral hygiene, malnutrition, and sedative medications
We evaluated the number of bacteria in the oral cavity, oral hygiene, and serum biomarkers among three groups: aspiration pneumonia (AP), community-acquired pneumonia (CAP), and control (Con)
There was no significant difference between the AP and the CAP group; the Con group was significantly younger than the AP and CAP groups
Summary
Aspiration pneumonia is a serious problem among elderly patients; it is caused by many risk factors including dysphagia, poor oral hygiene, malnutrition, and sedative medications. The aim of this study was to define a convenient procedure to objectively evaluate the risk of aspiration pneumonia in the clinical setting. One important risk factor for aspiration pneumonia is oral health [8]. An oral bacterial count-measuring device has been developed in the dental field to check the condition of the oral cavity [9]. Using this device, oral bacteria counts in the elderly have been shown to be a risk factor for aspiration pneumonia [10]. In many clinical situations such as nursing care in residential care facilities, it is difficult for the Nishizawa et al BMC Infectious Diseases (2019) 19:761 experts to perform oral care; it is important to standardize oral care procedures and to objectively assess the quality of oral care
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