每日刷牙与住院肺炎之间的关联:系统性审查和元分析
Selina Ehrenzeller1,2,3, Michael Klompas1,2
1Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.
JAMA internal medicine
|December 18, 2023
概括
每天刷牙显著降低了医院获得的肺炎 (HAP) 和重症监护室 (ICU) 死亡率. 这种简单的干预也缩短了机械通风的持续时间和ICU停留时间,改善了患者的治疗结果.
科学领域:
- 与医疗保健相关的感染
- 关键护理医学 关键护理医学
- 公共卫生干预措施 公共卫生干预措施
背景情况:
- 在医院获得的肺炎 (HAP) 是医疗保健机构中致病和死亡的主要原因.
- 对HAP的有效预防策略仍然有限,需要研究简单但有影响力的干预措施.
研究的目的:
- 评估每天刷牙与高血压病发病率之间的关联.
- 评估牙刷对其他关键患者结局的影响,包括死亡率和停留时间.
主要方法:
- 一个系统的审查和随机临床试验的元分析涉及住院成年人.
- 在多个数据库 (PubMed,Embase等) 进行了搜索. 在2023年3月之前.
- 提取数据和评估偏差风险的重复,使用随机效应模型进行元分析.
主要成果:
- 每天刷牙与HAP (RR,0.67) 和ICU死亡率 (RR,0.81) 的风险显著降低.
- 对入侵通风患者来说,肺炎的减少是显著的.
- 在ICU中刷牙导致机械通风日减少 (MD, -1.24) 和ICU停留时间缩短 (MD, -1.78).
结论:
- 每天刷牙是一种潜在的有效策略,可以降低HAP的发生率,特别是在机械通风患者中.
- 这种干预与ICU死亡率降低,机械通风持续时间缩短和ICU停留时间缩短有关.
- 建议在医疗保健机构广泛实施和一致实践牙刷.
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