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RELATIONSHIP BETWEEN ORAL HEALTH CARE STATUS & INCIDENCE OF VENTILATOR ASSOCIATED PNEUMONIA IN AMONG ICU PATIENTS

Rashid Ahmed Khan, Zaib-un-nissa, Abdul Haque Khan, Syed Jahanghir & Shahrukh Qadeer

Abstract: Background Ventilator-associated pneumonia (VAP) is pneumonia that develops two days (48 hours) after ventilator placement (Center for Disease Control and Prevention, 2016). VAP is the most common type of nosocomial pneumonia and a leading cause of morbidity and mortality particularly among intensive care unit (ICU) patients Objective: To study the association between oral health and ventilator-associated pneumonia (VAP) among critically ill patients. Methods: A prospective cohort study was conducted among 162 critically ill patients, chosen via non-probability – consecutive sampling, of both genders, aged 18 and above and newly intubated and treated with mechanical ventilator at a tertiary hospital. After taking written informed consent from the study subjects, data was collected using a structured, interview based questionnaire containing inquiries about basic biodata, sociodemographic details and disease particulars. Oral health status was assessed using Oral Health Assessment Tool (OHAT) and Plaque Index (PI). Clinical Pulmonary Infection Score >6, was assessed on Day 4 after intubation. The data obtained was analyzed using MS. Excel 360 and SPSS v. 21.0. Result: Among the 162 patients, 38.9% were females, while the remaining 61.1% were males. The mean age of sample stood at 47 years (SD ± 11.3) and most (50.62%) of the subjects were aged 52 and above. The oral health status of patients deteriorated after intubation. Early-onset VAP developed in 69 patients (42.6%). Moderately unhealthy and unhealthy oral conditions based on OHAT scores were associated with a three-fold or higher increased risk of VAP. Patients with moderate-to-very poor oral hygiene assessed by PI had increased VAP risk of nearly two-folds. Conclusion: After careful consideration, it can be concluded that there is a strong association between poor oral health and increased risk for early-onset VAP. Routine oral care possibly prevents VAP development among critically ill patients treated with mechanical ventilator. Keywords: Ventilator Associated Pneumonia, Intensive Care Unit, Oral Health Status, Plaque Index & Intubation.

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