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2017 ; 17
(1
): 128
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English Wikipedia
The effect of a daily application of a 0 05% chlorhexidine oral rinse solution on
the incidence of aspiration pneumonia in nursing home residents: a multicenter
study
#MMPMID28629318
Hollaar VRY
; van der Putten GJ
; van der Maarel-Wierink CD
; Bronkhorst EM
; de Swart BJM
; Creugers NHJ
BMC Geriatr
2017[Jun]; 17
(1
): 128
PMID28629318
show ga
BACKGROUND: Dysphagia and potential respiratory pathogens in the oral biofilm are
risk factors for aspiration pneumonia in nursing home residents. The aim of the
study was to examine if the daily application of 0.05% chlorhexidine oral rinse
solution is effective in reducing the incidence of aspiration pneumonia in
nursing home residents with dysphagia. Associations between background variables
(age, gender, dysphagia severity, care dependency, medication use, number of
medical diagnoses, teeth and dental implants, and wearing removable dentures) and
the incidence of aspiration pneumonia were also examined. METHODS: This study is
a multicenter study in which for 1 year participants with dysphagia in the
intervention group received the usual oral hygiene care with the addition of a
0.05% chlorhexidine oral rinse solution, whereas participants in the control
group received only oral hygiene care. RESULTS: Data of 103 participants in 17
nursing homes were analyzed. Survival analysis showed no significant difference
in the incidence of pneumonia between both groups (Cox regression, HR = 0.800;
95% CI [0.368-1.737], p = 0.572). Cox regression analysis for Functional Oral
Intake Scale (FOIS)-level showed a significant risk of the incidence of pneumonia
(HR = 0.804; 95% CI [0.656-0.986], p = 0.036). After adjustment for Group and
FOIS-level, Cox multivariate proportional hazard regression analysis showed that
the variables age, gender, Care-dependency Scale-score (CDS) number of diseases,
medication use, number of teeth, and the presence of dental implants or removable
dentures were not significantly associated with the incidence of pneumonia.
CONCLUSIONS: Chlorhexidine oral rinse solution 0.05% as an adjunctive
intervention in daily oral hygiene care was not found to reduce incidence of
aspiration pneumonia. The requested number of participants to achieve sufficient
power was not established and high drop-out rate and non-structural compliance
was present. The power was considered to be sufficient to analyze the
associations between the background variables and the incidence of pneumonia in
the included nursing home residents with dysphagia. Dysphagia was found to be a
risk factor for aspiration pneumonia. TRIAL REGISTRATION: Registration in The
Netherlands National Trial Register: TC = 3515. Approval for the study was
obtained from the Medical Ethical Committee of the Radboud University Medical
Center (NL. nr:41,990.091.12).
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