Associations between oral health status and short-term functional outcomes in hospitalized patients aged over 65 years with acute ischemic stroke: a retrospective observational study

Takagi, Sahoko; Maeda, Keisuke; Shimizu, Akio; Yuasa, Hidemichi; Yamauchi, Keita; Sakai, Hideki

doi:10.1007/s00784-023-05352-0

Cited by 3 publications

(3 citation statements)

References 32 publications

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“…Although associations between poor oral health status and swallowing function in older patients have been reported [9][10][11], the generalizability of current studies is limited because of their cross-sectional or singlecenter nature. Therefore, this study aimed to determine these associations using a database that enrolled older patients with dysphagia in multiple settings, including acute care and rehabilitation.…”

Section: Introductionmentioning

confidence: 91%

“…The ROAG evaluates eight domains (voice, lips, saliva, swallow, mucous membrane, tongue, gums, and teeth/dentures), with scores ranging from 8 to 24. This study considered oral health poor if the OHAT score was three or above [3,4,11] or the ROAG score was 13 or above [4].…”

Section: Oral Health Status Evaluationmentioning

confidence: 99%

“…Several cross-sectional studies have reported an association between poor oral health and lower swallowing function [9,10]. Furthermore, in a single-center cohort study of older patients with stroke, poor oral health status was an inhibitory factor in improving swallowing function [11].…”

Section: Introductionmentioning

confidence: 99%

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Impact of Poor Oral Health Status on Swallowing Function Improvement in Older Dysphagic Patients

Shimizu,

Ohno,

Fujishima

et al. 2023

Cureus

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Background This study aimed to explore the relationship between poor oral health status and improvement in swallowing function in older patients with dysphagia across various clinical settings, including acute and post-acute care environments. Methods This retrospective cohort study encompassed patients aged 65 years and older with dysphagia. Oral health status was assessed using the oral health assessment tool (OHAT) or the revised oral assessment guide (ROAG). In this study, an OHAT score of ≥3 or an ROAG score of ≥13 indicated poor oral health status. The primary outcome measured was the change in the food intake level scale (FILS) score, which reflects swallowing function, during the observation period. The association between changes in FILS score and poor oral health status was analyzed using a multivariable linear regression model. Results The study included 361 older patients with dysphagia (mean age 82.7 ± 7.7 years; 47.3% male), of whom 82.5% had poor oral health. A negative association was found between poor oral health status and improvement in FILS score at the endpoint (partial regression coefficient: -0.523, 95% confidence interval: -0.99 to -0.06, P=0.026). Conclusions Our findings underscore the negative impact of poor oral health status on the improvement of swallowing function and emphasize the importance of oral health interventions for older patients. Further study on oral health interventions' effects on improving swallowing function in older patients with dysphagia is warranted.

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Section: Introductionmentioning

confidence: 91%

Section: Oral Health Status Evaluationmentioning

confidence: 99%

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Impact of Poor Oral Health Status on Swallowing Function Improvement in Older Dysphagic Patients

Shimizu,

Ohno,

Fujishima

et al. 2023

Cureus

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Oral condition at admission predicts functional outcomes and hospital-acquired pneumonia development among acute ischemic stroke patients

Eto,

Nezu,

Nishi

et al. 2024

Clin Oral Invest

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Introduction Oral care is crucial for the prevention of cardiovascular events and pneumonia. However, few studies have evaluated the associations between multidimensional assessments of oral status or functional outcomes and hospital-acquired pneumonia (HAP). Methods Consecutive patients with acute ischemic stroke (AIS) were retrospectively analyzed. We evaluated the modified oral assessment grade (mOAG) and investigated its association with a modified Rankin scale (mRS) score of 0‒2 (good stroke outcome) and HAP. The mOAG was developed to evaluate 8 categories (lip, tongue, coated tongue, saliva, mucosa, gingiva, preservation, and gargling) on a 4-point scale ranging from 0 to 3. We analyzed the effectiveness of the mOAG score for predicting stroke outcome or HAP using receiver operating characteristic (ROC) curve analysis. Results In total, 247 patients with AIS were analyzed. The area under the ROC curve of the mOAG for predicting poor outcomes was 0.821 (cutoff value: 7), and that for HAP incidence was 0.783 (cutoff value: 8). mOAG (a one-point increase) was associated with poor stroke outcome (odds ratio [OR] 1.31, 95% confidence interval [CI] 1.17‒1.48, P < 0.001) and HAP (OR 1.21, 95% CI 1.07‒1.38, P = 0.003) after adjusting for baseline clinical characteristics, including age and stroke severity. Conclusions Lower mOAG scores at admission were independently associated with good outcomes and a decreased incidence of HAP. Comprehensive oral assessments are essential for acute stroke patients in clinical settings.

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Oral Health in Patients Hospitalized Because of Ischemic Stroke

Dziewulska,

Pawlukowska,

Zawiślak

et al. 2024

JCM

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Background/Objectives: Maintenance of good oral health is relevant to overall health and quality of life. Results of many analyses showed that stroke patients had worse oral health than the control population. The aim of this study was a clinical assessment of oral condition in post-stroke patients and a healthy population. Methods: Oral health was assessed in stroke patients on the first day of ischemic stroke, and in a control group of healthy subjects. The number of teeth, the presence of active carious foci, fillings, and prosthetic restorations were evaluated. To assess oral hygiene, the Approximal Plaque Index (API) was used. In periodontal examinations, the presence of dental deposits, the depth of the existing periodontal pockets, tooth mobility, and the Sulcus Bleeding Index (SBI) during probing were assessed. Results: Significantly higher mean values of Decayed Teeth (DT), Missing Teeth (MT), and Decayed, Missing, and Filled Teeth (DMFT) indices were recorded in the study group. The incidence of dental caries, API, and SBI was also significantly higher in the study group. The study and control groups did not differ significantly in the average number of pockets 3 mm deep and deeper and in the frequency of having prosthetic restorations. Conclusions: Oral health and the level of oral hygiene in patients hospitalized because of ischemic stroke, in comparison with that in a healthy population, is not satisfactory. Active interdisciplinary collaboration between various medical specialists in the therapy of patients with general illnesses, including stroke, is strongly recommended.

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Associations between oral health status and short-term functional outcomes in hospitalized patients aged over 65 years with acute ischemic stroke: a retrospective observational study

Cited by 3 publications

References 32 publications

Impact of Poor Oral Health Status on Swallowing Function Improvement in Older Dysphagic Patients

Impact of Poor Oral Health Status on Swallowing Function Improvement in Older Dysphagic Patients

Oral condition at admission predicts functional outcomes and hospital-acquired pneumonia development among acute ischemic stroke patients

Oral Health in Patients Hospitalized Because of Ischemic Stroke

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