ワカバヤシ ヒデタカ   Wakabayashi Hidetaka
  若林 秀隆
   所属   医学部 医学科(東京女子医科大学病院)
   職種   教授・基幹分野長
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Hospital dental hygienist intervention improves activities of daily living, home discharge and mortality in post-acute rehabilitation.
掲載誌名 正式名:Geriatrics & gerontology international
略  称:Geriatr Gerontol Int
ISSNコード:14470594/14470594
掲載区分国外
巻・号・頁 19(3),pp.189-196
著者・共著者 Shiraishi Ai, Yoshimura Yoshihiro, Wakabayashi Hidetaka, Tsuji Yuri, Yamaga Makio, Koga Hiroaki
発行年月 2019/03
概要 AIM:To examine the effects of oral management provided by dental hygienists (DH) on patient outcomes in post-acute rehabilitation.METHODS:We carried out a retrospective cohort study with 1056 patients newly admitted to a post-rehabilitation hospital in Japan. DH care was defined as two or more consecutive instances of oral management provided by a ward DH during hospitalization. The primary outcome was the motor domain of Functional Independence Measure score at discharge. Other outcomes included the rate of home discharge; length of stay, all-cause in-hospital mortality, and oral, swallowing and nutritional status at discharge. Propensity score matching was carried out to control and adjust for patients' backgrounds to compare outcomes between patients who did or did not receive DH care.RESULTS:Of 1056 patients enrolled (mean age 71 years; 52.0% women; 73.1% with oral problems), 415 (39.3%) received DH care. Multivariate analyses using pair-matched patients showed that DH care was significantly associated with higher motor domain of Functional Independence Measure score at discharge (β = 0.281, P = 0.041), shorter length of stay (β = 0.446, P = 0.044), higher rate of home discharge (odds ratio 1.202, 95% confidence interval 1.026-1.491, P = 0.037) and lower mortality (hazard ratio 0.818, 95% confidence interval 0.738-0.952, P = 0.037) after adjusting for potential covariates.CONCLUSIONS:DH oral management improves patient outcomes, including activities of daily living, home discharge and in-hospital mortality in post-acute rehabilitation. Early detection of oral problems, early oral treatment by dental professionals, and cooperation between medical and dental professionals should be implemented. Geriatr Gerontol Int 2019; 19: 189-196.
DOI 10.1111/ggi.13583
PMID 30517977