Factor Analysis on Onset of Ventilator-Associated Pneumonia for Inpatients in the Intensive Care Unit

Abstract

The objective of the present study is toassess risk factors" at the stage of proofs, including oral health status, with the development of VAP in perioperative patients, with the final aim of the establishing oral health management systems in acute care hospitals. Of the patients who were admitted to the Intensive Care Unit (ICU) of our university hospital from January to December 2011 and who underwent oral intubation, 11 patients who received a diagnosis of VAP (nine men and two women) and 11 control patients (eight men and three women) were selected as subjects for the present study. We first investigated the disease names listed in the medical records of subjects in the VAP group and then selected patients who had the same diseases as the control group subjects. Within one day after admission to the ICU, a dentist evaluated the oral health status of the patients and the lips, teeth, oral mucosa, gingiva, tongue and xerostomia were scored (0-12) based on the criteria of the Revised Oral Assessment Guide (ROAG). Furthermore, six items (operative duration, BMI, length of ICU stay, Acute Physiology and Chronic Health Evaluation (APACHE II) score and length of ventilator used) were extracted from patient medical records and investigated. The items were used as independent variables and their relationship with the development of VAP was examined by regression analysis. Oral health care was performed by a nurse four times per day, using a standard toothbrush or sponge brush. Moreover, this study was approved by the Ethics Committee of the Department of Dentistry in our university. When each factor was compared in the VAP group and the control group, the VAP group showed significantly higher scores for oral health status, length of ICU stay and length of ventilator used. Furthermore, when the development of VAP and the relationships with each factor were examined by regression analysis, a significant relationship with oral health status, operative duration, BMI and length of ventilator use was seen. The results of the present study suggest the possibility of various factors being involved in the development of VAP in orally intubated patients, such as the oral health status of the patient. Appropriate oral health care can aid the prevention of perioperative pulmonary infections.