Impact of oral health status on oral intake ability prognosis after pneumonia in older patients: a retrospective cohort study

Abstract

Background and purpose: Older dysphagic patients with pneumonia are frequently managed with a nil per os regimen on admission. This practice could lead to worse oral health and outcomes after pneumonia. The aim of this study is to examine the hypothesis that oral health status has an effect on oral intake prognosis after pneumonia in older adults. Methods: This retrospective observational study evaluated data on consecutive in-patients with pneumonia aged > 65 years in an acute care ward. We compared baseline characteristics and outcomes between two groups with or without oral health problems assessed using the Oral Health Assessment Tool. Primary outcome was attaining total oral intake (Functional Oral Intake Scale) at discharge. Secondary outcome was length of hospital stay. Results: After applying exclusion criteria, 162 patients were eligible for analysis; 113 (70.0%) had oral health problems. Patients without oral health problems had higher rates of total oral intake at discharge than patients with oral health problems (69.4% vs. 49.6%; p = 0.03). Patients without oral health problems had shorter length of hospital stay than patients with oral health problems (mean, 30.6 days vs. 41.3 days; p = 0.03). Multiple logistic regression analysis identified oral health problems as a significant factor for total oral intake at discharge (odds ratio, 0.45; 95% confidence interval, 0.21–0.98). Multiple linear regression analysis revealed that oral health problems significantly affected length of hospital stay (coefficient, 11.0; 95% confidence interval, 1.2–20.7). Conclusion: Our data demonstrated that poor oral health status was associated with poor oral intake ability prognosis in patients with pneumonia in acute care.