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Aspiration pneumonia: Dental and oral risk factors in an older veteran population

Identifieur interne : 008B38 ( Main/Curation ); précédent : 008B37; suivant : 008B39

Aspiration pneumonia: Dental and oral risk factors in an older veteran population

Auteurs : Margaret S. Terpenning [États-Unis] ; George W. Taylor [États-Unis] ; Dennis E. Lopatin [États-Unis] ; Connie Kinder Kerr [États-Unis] ; B. Liza Dominguez [États-Unis] ; Walter J. Loesche [États-Unis]

Source :

RBID : Pascal:01-0320081

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English descriptors

Abstract

OBJECTIVES: To investigate the importance of medical and dental factors in aspiration pneumonia in an older veteran population. DESIGN: Prospective enrollment of subjects with retrospective analysis of data. SETTING: Department of Veterans Affairs outpatient clinic, inpatient ward, and nursing home. PARTICIPANTS: 358 veterans age 55 and older; 50 subjects with aspiration pneumonia. MEASUREMENTS: Demographic and medical data; functional status; health-related behaviors; dental care utilization; personal oral hygiene; comprehensive dental examination; salivary assays including IgA antibodies; and cultures of saliva, throat, and dental plaques. RESULTS: Two logistic regression models produced estimates of significant risk factors. One model using dentate patients included: requiring help with feeding (odds ratio (OR) = 13.9), chronic obstructive pulmonary disease (COPD) (OR = 4.7), diabetes mellitus (OR = 3.5), number of decayed teeth (OR = 1.2), number of functional dental units (OR = 1.2), presence of important organisms for decay, Streptococcus sobrinus in saliva (OR = 6.2), and periodontal disease, Porphyromonous gingivalis in dental plaque (OR = 4.2), and Staphylococcus aureus presence in saliva (OR = 7.4). The second model, containing both dentate and edentulous patients included: requiring help with feeding (OR = 4.7), COPD (OR = 2.5), diabetes mellitus (OR = 1.7), and presence of S. aureus in saliva (OR = 8.3). CONCLUSION: This study supports the significance of oral and dental factors while controlling for established medical risk factors in aspiration pneumonia incidence.

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Pascal:01-0320081

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<term>Aged, 80 and over</term>
<term>Aspiration pneumonia</term>
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<term>Mouth, Edentulous (complications)</term>
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<term>Pneumonia, Aspiration (etiology)</term>
<term>Public health</term>
<term>Risk Factors</term>
<term>Risk factor</term>
<term>Saliva (microbiology)</term>
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<term>Staphylococcal Infections (microbiology)</term>
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<term>Bronchopneumopathies obstructives</term>
<term>Caries dentaires</term>
<term>Complications du diabète</term>
<term>Facteurs de l'âge</term>
<term>Facteurs de risque</term>
<term>Humains</term>
<term>Incidence</term>
<term>Infections à staphylocoques</term>
<term>Infections à streptocoques</term>
<term>Modèles logistiques</term>
<term>Plaque dentaire</term>
<term>Pneumopathie aspiration</term>
<term>Dent pathologie</term>
<term>Epidémiologie</term>
<term>Facteur risque</term>
<term>Personne âgée</term>
<term>Répartition par âge</term>
<term>Santé buccodentaire</term>
<term>Santé publique</term>
<term>Ancien combattant</term>
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<term>Streptococcus sobrinus</term>
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<term>Sujet âgé de 80 ans ou plus</term>
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<term>Etats Unis</term>
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<front>
<div type="abstract" xml:lang="en">OBJECTIVES: To investigate the importance of medical and dental factors in aspiration pneumonia in an older veteran population. DESIGN: Prospective enrollment of subjects with retrospective analysis of data. SETTING: Department of Veterans Affairs outpatient clinic, inpatient ward, and nursing home. PARTICIPANTS: 358 veterans age 55 and older; 50 subjects with aspiration pneumonia. MEASUREMENTS: Demographic and medical data; functional status; health-related behaviors; dental care utilization; personal oral hygiene; comprehensive dental examination; salivary assays including IgA antibodies; and cultures of saliva, throat, and dental plaques. RESULTS: Two logistic regression models produced estimates of significant risk factors. One model using dentate patients included: requiring help with feeding (odds ratio (OR) = 13.9), chronic obstructive pulmonary disease (COPD) (OR = 4.7), diabetes mellitus (OR = 3.5), number of decayed teeth (OR = 1.2), number of functional dental units (OR = 1.2), presence of important organisms for decay, Streptococcus sobrinus in saliva (OR = 6.2), and periodontal disease, Porphyromonous gingivalis in dental plaque (OR = 4.2), and Staphylococcus aureus presence in saliva (OR = 7.4). The second model, containing both dentate and edentulous patients included: requiring help with feeding (OR = 4.7), COPD (OR = 2.5), diabetes mellitus (OR = 1.7), and presence of S. aureus in saliva (OR = 8.3). CONCLUSION: This study supports the significance of oral and dental factors while controlling for established medical risk factors in aspiration pneumonia incidence.</div>
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<name sortKey="Taylor, George W" sort="Taylor, George W" uniqKey="Taylor G" first="George W." last="Taylor">George W. Taylor</name>
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<s1>Department of Cardiology, Restorative Sciences, and Endodontics</s1>
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<name sortKey="Lopatin, Dennis E" sort="Lopatin, Dennis E" uniqKey="Lopatin D" first="Dennis E." last="Lopatin">Dennis E. Lopatin</name>
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<s1>Department Biologic and Materials Sciences, University of Michigan School of Dentistry</s1>
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<name sortKey="Liza Dominguez, B" sort="Liza Dominguez, B" uniqKey="Liza Dominguez B" first="B." last="Liza Dominguez">B. Liza Dominguez</name>
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<region type="state">Michigan</region>
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<name sortKey="Loesche, Walter J" sort="Loesche, Walter J" uniqKey="Loesche W" first="Walter J." last="Loesche">Walter J. Loesche</name>
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<s1>University of Michigan School of Nursing</s1>
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<region type="state">Michigan</region>
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<title level="j" type="main">Journal of the American Geriatrics Society</title>
<title level="j" type="abbreviated">J. Am. Geriatr. Soc.</title>
<idno type="ISSN">0002-8614</idno>
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<date when="2001">2001</date>
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<title level="j" type="main">Journal of the American Geriatrics Society</title>
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<idno type="ISSN">0002-8614</idno>
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<keywords scheme="KwdEn" xml:lang="en">
<term>Aspiration pneumonia</term>
<term>Dental disease</term>
<term>Elderly</term>
<term>Epidemiology</term>
<term>Public health</term>
<term>Risk factor</term>
<term>Trauma</term>
<term>United States</term>
<term>Veteran</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr">
<term>Pneumopathie aspiration</term>
<term>Dent pathologie</term>
<term>Epidémiologie</term>
<term>Facteur risque</term>
<term>Personne âgée</term>
<term>Santé publique</term>
<term>Ancien combattant</term>
<term>Traumatisme</term>
<term>Etats Unis</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr">
<term>Personne âgée</term>
<term>Santé publique</term>
<term>Ancien combattant</term>
<term>Traumatisme</term>
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<div type="abstract" xml:lang="en">OBJECTIVES: To investigate the importance of medical and dental factors in aspiration pneumonia in an older veteran population. DESIGN: Prospective enrollment of subjects with retrospective analysis of data. SETTING: Department of Veterans Affairs outpatient clinic, inpatient ward, and nursing home. PARTICIPANTS: 358 veterans age 55 and older; 50 subjects with aspiration pneumonia. MEASUREMENTS: Demographic and medical data; functional status; health-related behaviors; dental care utilization; personal oral hygiene; comprehensive dental examination; salivary assays including IgA antibodies; and cultures of saliva, throat, and dental plaques. RESULTS: Two logistic regression models produced estimates of significant risk factors. One model using dentate patients included: requiring help with feeding (odds ratio (OR) = 13.9), chronic obstructive pulmonary disease (COPD) (OR = 4.7), diabetes mellitus (OR = 3.5), number of decayed teeth (OR = 1.2), number of functional dental units (OR = 1.2), presence of important organisms for decay, Streptococcus sobrinus in saliva (OR = 6.2), and periodontal disease, Porphyromonous gingivalis in dental plaque (OR = 4.2), and Staphylococcus aureus presence in saliva (OR = 7.4). The second model, containing both dentate and edentulous patients included: requiring help with feeding (OR = 4.7), COPD (OR = 2.5), diabetes mellitus (OR = 1.7), and presence of S. aureus in saliva (OR = 8.3). CONCLUSION: This study supports the significance of oral and dental factors while controlling for established medical risk factors in aspiration pneumonia incidence.</div>
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<name sortKey="Dominguez, B L" sort="Dominguez, B L" uniqKey="Dominguez B" first="B L" last="Dominguez">B L Dominguez</name>
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<term>Aged, 80 and over</term>
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<term>Dental Plaque</term>
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<term>Staphylococcal Infections</term>
<term>Streptococcal Infections</term>
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<term>Pneumopathie de déglutition</term>
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<term>Pneumopathie de déglutition</term>
</keywords>
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<term>Activities of Daily Living</term>
<term>Age Distribution</term>
<term>Age Factors</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Diabetes Complications</term>
<term>Geriatric Assessment</term>
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<term>Activités de la vie quotidienne</term>
<term>Anciens combattants</term>
<term>Bouche édentée</term>
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<term>Sujet âgé de 80 ans ou plus</term>
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<div type="abstract" xml:lang="en">To investigate the importance of medical and dental factors in aspiration pneumonia in an older veteran population.</div>
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