老年住院患者口腔健康与衰弱的相关性  

Correlation between oral health and frailty in elderly inpatients

作　　者：于建娇 朱火兰[2] 张玉莲[3] 王丹[4] 郭花 张慧瑛 来锦 Yu Jianjiao;Zhu Huolan;Zhang Yulian;Wang Dan;Guo Hua;Zhang Huiying;Lai Jin(Faculty of Nursing,Health Science Centre,Xi′an Jiaotong University,Xi′an 710061,China;Department of Geriatrics,Shaanxi Provincial People′s Hospital,Xi'an 710068,China;Director′s Office,Shaanxi Provincial People′s Hospital,Xi'an 710068,China;Department of Nursing,Shaanxi Provincial People′s Hospital,Xi'an 710068,China;Faculty of Nursing,Health Science Centre,Yan′an University,Yan′an 716000,Shaanxi Province,China;Faculty of Nursing,Shaanxi University of Traditional Chinese Medicine,Xianyang 712046,Shaanxi Province,China)

机构地区：[1]西安交通大学医学部护理学系,西安710061 [2]陕西省人民医院老年病院,西安710068 [3]陕西省人民医院院长办公室,西安710068 [4]陕西省人民医院护理部,西安710068 [5]延安大学医学部护理学系,陕西延安716000 [6]陕西中医药大学护理学系,陕西咸阳712046

出　　处：《中华老年多器官疾病杂志》2023年第9期652-657,共6页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：陕西省2020年重点研发计划(2020ZDLSF01-08);陕西省自然科学基础研究计划(2022JQ-925)。

摘　　要：目的了解老年住院患者衰弱及口腔健康现状,分析口腔健康对衰弱的影响,为针对性干预提供依据。方法采用便利抽样法,抽取2022年5月至11月陕西省人民医院老年病院700例老年住院患者为研究对象,使用一般资料调查表、老年口腔健康评价指数和Tilburg衰弱评估量表进行调查,其中685例患者的调查问卷为有效问卷。依据Tilburg衰弱评估量表得分将患者分为非衰弱组(n=347)和衰弱组(n=338),比较2组患者一般资料与口腔健康状况的差异。采用SPSS 26.0统计软件进行数据分析。根据数据类型,分别采用Mann-Whitney U检验或χ^(2)检验进行组间比较。采用Spearman相关分析衰弱与口腔健康及各维度的相关性。采用多因素logistic回归分析衰弱的影响因素。结果老年住院患者合并衰弱占比为49.3%(338/685),口腔健康得分为54(48,57)分,处于中等水平,衰弱组患者的口腔健康总分及各维度得分均显著低于非衰弱组患者(P<0.01)。Spearman相关分析显示,口腔健康与衰弱呈显著负相关(r=-0.599,P<0.01)。Logistic回归分析显示,年龄更大(OR=1.043,95%CI 1.009~1.079)、未/离婚或丧偶(OR=2.226,95%CI 1.176~4.211)、多重用药(OR=1.986,95%CI 1.329~2.968)、牙齿掉落个数越多(OR=1.054,95%CI 1.016~1.093)、近1年有口腔溃疡(OR=1.930,95%CI 1.111~3.351)、口腔健康中等水平(OR=4.345,95%CI 2.437~7.747)和低等水平(OR=9.149,95%CI 4.454~18.795)为老年住院患者衰弱的危险因素;体育锻炼(OR=0.596,95%CI 0.403~0.881)为其保护因素。结论老年住院患者口腔健康与衰弱密切相关,口腔健康水平越低其衰弱发生率越高。医护人员应重视对老年人口腔健康的识别和筛查,将口腔健康纳入衰弱老年人健康管理的工作范畴,通过积极的早期干预,延缓衰弱的进展。Objective To explore the status of frailty and oral health in elderly inpatients and analyze the impact of oral health on frailty,so as to provide evidence for targeted intervention.Methods A total of 700 elderly inpatients were subjected from the Geriatric Hospital of Shaanxi Provincial People′s Hospital from May to November 2022 by convenience sampling.All of them were investigated by the general information sheet,geriatric oral health assessment index(GOHAI),and Tilburg frailty index(TFI).Among them,685 patients had valid questionnaires.According to the score of TFI,they were divided into non-frailty(n=347)and frailty(n=338)groups.Their general data and status of oral health were compared between the two groups.SPSS statistics 26.0 was used to analyze the data.Mann-Whitney U test or Chi-square test was employed for comparison between groups depending on data type.Spearman correlation analysis was applied to analyze the correlation between frailty and oral health.Multivariate logistic regression analysis was performed to analyze the influencing factors of frailty.Results The ratio of frailty was 49.3%(338/685)in the subjected elderly inpatients,and the score of GOHAI was 54(48,57)points,which was at a medium level.The total score of GOHAI and the scores of each dimension were significantly lower in the frailty group than the non-frailty group(P<0.01).Spearman correlation analysis showed that oral health was negatively correlated with frailty(r=-0.599,P<0.01).Multivariate logistic regression analysis revealed that advanced age(OR=1.043,95%CI 1.009-1.079),unmarried/divorced/widowed(OR=2.226,95%CI 1.176-4.211),poly-pharmacy(OR=1.986,95%CI 1.329-2.968),larger number of decayed teeth(OR=1.054,95%CI 1.016-1.093),oral ulcer in the past year(OR=1.930,95%CI 1.111-3.351),and medium(OR=4.345,95%CI 2.437-7.747)and low(OR=9.149,95%CI 4.454-18.795)levels of oral health were risk factors for frailty in the elderly inpatients,while physical exercise(OR=0.596,95%CI 0.403-0.881)was a protective factor(all P<0.05).Conclusion Or

关 键 词：老年人 衰弱 口腔健康 住院患者 

分 类 号：R212.7[医药卫生—中医学]