Current Status of Preoperative Professional Oral Care by Dentists for Elderly Patients Undergoing Lung Resection and Occurrence of Postoperative Pneumonia

Yasushi Hoshikawa, Naoko Tanda, Yasushi Matsuda, Hiroshi Katsumata, Hirotsugu Notsuda, Tatsuaki Watanabe, Hiromichi Niikawa, Masafumi Noda, Akira Sakurada, Takashi Kondo, Yoshinori Okada

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Pneumonia in elderly people is mainly caused by silent aspiration due to an age-related impairment of cough and swallowing reflexes. Because most of the patients with lung cancer are elderly people, we hypothesized that the age-related impairment of these protective reflexes might exist or occur in patients undergoing lung surgery, and cause postoperative pneumonia. We revealed that many elderly patients showed depressed swallowing reflex even before surgery and transient attenuation of cough reflex after surgery, and that postoperative pneumonia occurred only in the patients whose cough and/or swallowing reflex was abnormal postoperatively. Then, we prospectively showed that 30 elderly patients who received perioperative intensive oral care, including professional assessment of oral status, dental cleaning, and patient education for self-oral care by dentists, followed by intensive oral care by intensive care unit nurses, and encouragement of self-oral care by floor nurses, did not develop pneumonia after lung resection. In this study, we retrospectively reviewed the execution status of professional oral care by dentists and the occurrence of postoperative pneumonia in 159 consecutive patients aged 65 or older undergoing lung resection from 2013 to 2014. Thoracic surgeons in our institute asked dentists to provide professional oral care before lung resection only in 30.3% of the subjects in 2013, and 45.8% in 2014. Postoperative pneumonia occurred in 3 out of 76 subjects(3.9%)in 2013, and 1 out of 83(1.2%) in 2014. In 2013, 1 patient who did not receive preoperative professional oral care developed aspiration pneumonia postoperatively followed by acute exacerbation of idiopathic pulmonary fibrosis and in-hospital death. We need to make an effective system to provide preoperative professional oral care by dentists especially for elderly patients and high-risk patients before lung resection.

Original languageEnglish
Pages (from-to)25-29
Number of pages5
JournalKyobu geka. The Japanese journal of thoracic surgery
Volume69
Issue number1
Publication statusPublished - 01-01-2016

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Dentists
Pneumonia
Lung
Reflex
Deglutition
Cough
Critical Care
Self Care
Nurses
Dental Education
Mouth Floor
Aspiration Pneumonia
Abnormal Reflexes
Idiopathic Pulmonary Fibrosis
Patient Education
Intensive Care Units
Lung Neoplasms
Thorax

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Hoshikawa, Yasushi ; Tanda, Naoko ; Matsuda, Yasushi ; Katsumata, Hiroshi ; Notsuda, Hirotsugu ; Watanabe, Tatsuaki ; Niikawa, Hiromichi ; Noda, Masafumi ; Sakurada, Akira ; Kondo, Takashi ; Okada, Yoshinori. / Current Status of Preoperative Professional Oral Care by Dentists for Elderly Patients Undergoing Lung Resection and Occurrence of Postoperative Pneumonia. In: Kyobu geka. The Japanese journal of thoracic surgery. 2016 ; Vol. 69, No. 1. pp. 25-29.
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abstract = "Pneumonia in elderly people is mainly caused by silent aspiration due to an age-related impairment of cough and swallowing reflexes. Because most of the patients with lung cancer are elderly people, we hypothesized that the age-related impairment of these protective reflexes might exist or occur in patients undergoing lung surgery, and cause postoperative pneumonia. We revealed that many elderly patients showed depressed swallowing reflex even before surgery and transient attenuation of cough reflex after surgery, and that postoperative pneumonia occurred only in the patients whose cough and/or swallowing reflex was abnormal postoperatively. Then, we prospectively showed that 30 elderly patients who received perioperative intensive oral care, including professional assessment of oral status, dental cleaning, and patient education for self-oral care by dentists, followed by intensive oral care by intensive care unit nurses, and encouragement of self-oral care by floor nurses, did not develop pneumonia after lung resection. In this study, we retrospectively reviewed the execution status of professional oral care by dentists and the occurrence of postoperative pneumonia in 159 consecutive patients aged 65 or older undergoing lung resection from 2013 to 2014. Thoracic surgeons in our institute asked dentists to provide professional oral care before lung resection only in 30.3{\%} of the subjects in 2013, and 45.8{\%} in 2014. Postoperative pneumonia occurred in 3 out of 76 subjects(3.9{\%})in 2013, and 1 out of 83(1.2{\%}) in 2014. In 2013, 1 patient who did not receive preoperative professional oral care developed aspiration pneumonia postoperatively followed by acute exacerbation of idiopathic pulmonary fibrosis and in-hospital death. We need to make an effective system to provide preoperative professional oral care by dentists especially for elderly patients and high-risk patients before lung resection.",
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Hoshikawa, Y, Tanda, N, Matsuda, Y, Katsumata, H, Notsuda, H, Watanabe, T, Niikawa, H, Noda, M, Sakurada, A, Kondo, T & Okada, Y 2016, 'Current Status of Preoperative Professional Oral Care by Dentists for Elderly Patients Undergoing Lung Resection and Occurrence of Postoperative Pneumonia', Kyobu geka. The Japanese journal of thoracic surgery, vol. 69, no. 1, pp. 25-29.

Current Status of Preoperative Professional Oral Care by Dentists for Elderly Patients Undergoing Lung Resection and Occurrence of Postoperative Pneumonia. / Hoshikawa, Yasushi; Tanda, Naoko; Matsuda, Yasushi; Katsumata, Hiroshi; Notsuda, Hirotsugu; Watanabe, Tatsuaki; Niikawa, Hiromichi; Noda, Masafumi; Sakurada, Akira; Kondo, Takashi; Okada, Yoshinori.

In: Kyobu geka. The Japanese journal of thoracic surgery, Vol. 69, No. 1, 01.01.2016, p. 25-29.

Research output: Contribution to journalArticle

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AU - Hoshikawa, Yasushi

AU - Tanda, Naoko

AU - Matsuda, Yasushi

AU - Katsumata, Hiroshi

AU - Notsuda, Hirotsugu

AU - Watanabe, Tatsuaki

AU - Niikawa, Hiromichi

AU - Noda, Masafumi

AU - Sakurada, Akira

AU - Kondo, Takashi

AU - Okada, Yoshinori

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Y1 - 2016/1/1

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AB - Pneumonia in elderly people is mainly caused by silent aspiration due to an age-related impairment of cough and swallowing reflexes. Because most of the patients with lung cancer are elderly people, we hypothesized that the age-related impairment of these protective reflexes might exist or occur in patients undergoing lung surgery, and cause postoperative pneumonia. We revealed that many elderly patients showed depressed swallowing reflex even before surgery and transient attenuation of cough reflex after surgery, and that postoperative pneumonia occurred only in the patients whose cough and/or swallowing reflex was abnormal postoperatively. Then, we prospectively showed that 30 elderly patients who received perioperative intensive oral care, including professional assessment of oral status, dental cleaning, and patient education for self-oral care by dentists, followed by intensive oral care by intensive care unit nurses, and encouragement of self-oral care by floor nurses, did not develop pneumonia after lung resection. In this study, we retrospectively reviewed the execution status of professional oral care by dentists and the occurrence of postoperative pneumonia in 159 consecutive patients aged 65 or older undergoing lung resection from 2013 to 2014. Thoracic surgeons in our institute asked dentists to provide professional oral care before lung resection only in 30.3% of the subjects in 2013, and 45.8% in 2014. Postoperative pneumonia occurred in 3 out of 76 subjects(3.9%)in 2013, and 1 out of 83(1.2%) in 2014. In 2013, 1 patient who did not receive preoperative professional oral care developed aspiration pneumonia postoperatively followed by acute exacerbation of idiopathic pulmonary fibrosis and in-hospital death. We need to make an effective system to provide preoperative professional oral care by dentists especially for elderly patients and high-risk patients before lung resection.

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