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The association of oral health with length of stay and mortality in the intensive care unit

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Abstract

Objectives

To analyze the relationship between the oral and systemic health status of adult patients admitted to the intensive care unit (ICU) with the length of stay and mortality.

Material and methods

A daily oral examination and oral hygiene were performed in patients admitted to an adult ICU. Dental and oral lesions, systemic health status, the need for mechanical ventilation, length of stay, and mortality were registered. Multivariate linear and logistic regression analyses were performed to identify associations between length of stay and death of patients, respectively, with oral and systemic health status.

Results

In total, 207 patients were included, 107 (51.7%) male. Ventilated patients presented an increased length of stay (p < 0.001), mortality (p < 0.0001), number of medications (p < 0.0001), edentulism (p = 0.001), mucous lesions and bleeding (p < 0.0001), oropharyngitis (p = 0.03), and drooling (p < 0.001) compared to non-ventilated patients. The number of days in the ICU was associated with mechanical ventilation (p = 0.04), nosocomial pneumonia (p = 0001), end-stage renal disease (p < 0.0007), death (p < 0.0001), mucous bleeding (p = 0.01), tongue coating (p = 0.001), and cheilitis (p = 0.01). Mortality was associated with length of stay in the ICU (p < 0.0001), number of medications (p < 0.0001), and the need for mechanical ventilation (p = 0.006).

Conclusion

ICU patients present poor oral health. Soft tissue biofilm and mucous ulcerations were associated with the length of stay in the ICU, but not with the mortality rate.

Clinical relevance

Mucous lesions are associated with an increased length of stay in the ICU, and critically ill patients should receive oral care to control oral foci of infection and mucous lesions.

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Data Availability

Patient data are confidential, but the authors make themselves available to share the data from the spreadsheets obtained with those responsible for the journal, if necessary.

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Acknowledgements

The authors thank the Coordination for the Improvement of Higher Education Personnel (CAPES-Brasil), Irmandade Santa Casa de Londrina (Londrina-Brasil), and the company Dental Clean (Londrina, Brazil).

Author information

Authors and Affiliations

  1. Research Group On Tissue Regeneration, Adaptation, and Repair, Center of Biological Sciences, State University of Londrina, Londrina, PR, Brazil

    Erika Caroline Steinle, Jessica Antonia Montovani Pinesso & Solange de Paula Ramos

  2. Research Group On Tissue Regeneration, Adaptation, and Repair, North Parana University, Rua Marselha, Londrina, 678, Brazil

    Leonardo Bernardi Bellançon & Gabriela Fleury Seixas

Authors
  1. Erika Caroline Steinle
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  2. Jessica Antonia Montovani Pinesso
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  3. Leonardo Bernardi Bellançon
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  4. Solange de Paula Ramos
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  5. Gabriela Fleury Seixas
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Contributions

E.C.S: patient care, data collection, data analysis, and paper writing.

J.A.M.P: patient care, data collection, data analysis, and paper writing.

L.B.: patient care, data collection, and paper writing.

S.P.R: study design, data analysis, and paper writing.

G.F.S: project supervisor, study design, patient care, data collection, data analysis, and paper writing.

Corresponding author

Correspondence to Gabriela Fleury Seixas.

Ethics declarations

Ethical approval

The data collection procedures were approved by the Ethics Committee in Research Involving Human Beings of ISCAL-Irmandade Santa Casa de Londrina (protocol no. 3.202.350).

Informed consent

Patients or their guardians (in cases of unconsciousness) were informed of the research objectives, and data collection was performed only after authorization and signing of a written free and informed consent.

Conflict of interest

The authors declare no competing interests.

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Steinle, E.C., Pinesso, J.A.M., Bellançon, L.B. et al. The association of oral health with length of stay and mortality in the intensive care unit. Clin Oral Invest 27, 3875–3884 (2023). https://doi.org/10.1007/s00784-023-05008-z

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  • DOI: https://doi.org/10.1007/s00784-023-05008-z

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