Modification of the Risk of Mortality from Pneumonia with Oral Hygiene Care

Authors

  • Carol W. Bassim DMD, MS,

    1. From the *Dental Service, Washington, DC, Veterans Affairs Medical Center, Washington, District of ColumbiaDental Service, Fayetteville Veterans Affairs Medical Center, Fayetteville, ArizonaOffice of Dentistry, Department of Veterans Affairs, Washington, District of Columbia§Dental Service, Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Lake City, FloridaOffice of Dentistry, Department of Veterans Affairs, Washington, District of Columbia.
    Search for more papers by this author
  • Gretchen Gibson DDS, MPH,

    1. From the *Dental Service, Washington, DC, Veterans Affairs Medical Center, Washington, District of ColumbiaDental Service, Fayetteville Veterans Affairs Medical Center, Fayetteville, ArizonaOffice of Dentistry, Department of Veterans Affairs, Washington, District of Columbia§Dental Service, Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Lake City, FloridaOffice of Dentistry, Department of Veterans Affairs, Washington, District of Columbia.
    Search for more papers by this author
  • Timothy Ward DDS, MA,

    1. From the *Dental Service, Washington, DC, Veterans Affairs Medical Center, Washington, District of ColumbiaDental Service, Fayetteville Veterans Affairs Medical Center, Fayetteville, ArizonaOffice of Dentistry, Department of Veterans Affairs, Washington, District of Columbia§Dental Service, Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Lake City, FloridaOffice of Dentistry, Department of Veterans Affairs, Washington, District of Columbia.
    Search for more papers by this author
  • Brian M. Paphides DDS,

    1. From the *Dental Service, Washington, DC, Veterans Affairs Medical Center, Washington, District of ColumbiaDental Service, Fayetteville Veterans Affairs Medical Center, Fayetteville, ArizonaOffice of Dentistry, Department of Veterans Affairs, Washington, District of Columbia§Dental Service, Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Lake City, FloridaOffice of Dentistry, Department of Veterans Affairs, Washington, District of Columbia.
    Search for more papers by this author
  • and , Donald J. DeNucci DDS, MS

    1. From the *Dental Service, Washington, DC, Veterans Affairs Medical Center, Washington, District of ColumbiaDental Service, Fayetteville Veterans Affairs Medical Center, Fayetteville, ArizonaOffice of Dentistry, Department of Veterans Affairs, Washington, District of Columbia§Dental Service, Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Lake City, FloridaOffice of Dentistry, Department of Veterans Affairs, Washington, District of Columbia.
    Search for more papers by this author

Address correspondence to Carol W. Bassim, NIH/NIDCR/CRC, 10 Center Dr. Bldg 10, Rm 1N-118, MSC 1191, Bethesda, MD 20892. E-mail: bassimc@mail.nih.gov

Abstract

OBJECTIVES: To investigate the associations between the assignment of an oral hygiene aide staff member and risk factors for mortality from pneumonia in a nursing home and to test the hypothesis that this care would affect the incidence of mortality from pneumonia.

DESIGN: Electronic medical records.

SETTING: Nursing home.

PARTICIPANTS: One hundred forty-three residents of a Veterans Affairs Medical Center (VAMC) nursing home.

METHODS: The electronic medical records of 143 residents of a VAMC nursing home were analyzed for risk factors for pneumonia. A certified nursing assistant had been assigned to provide oral hygiene care for residents on two of four nursing home wards. Researchers performed a longitudinal analysis of resident's medical records to investigate the association between the assignment of an oral hygiene aide with the risk of mortality from pneumonia.

RESULTS: Initially, the group that received oral care, an older and less functionally able group, showed approximately the same incidence of mortality from pneumonia as the group that did not receive oral care, but when the data were adjusted for the risk factors found to be significant for mortality from pneumonia, the odds of dying from pneumonia in the group that did not receive oral care was more than three times that of the group that did receive oral care (odds ratio=3.57, P=.03). Modified risk factors included age, functionality, cognitive function, and clinical concern about aspiration pneumonia.

CONCLUSION: Oral hygiene nursing aide intervention may be an efficient risk factor modifier of mortality from nursing home–associated pneumonia.

Ancillary