Oral care measures for preventing nursing home‐acquired pneumonia

摘要: Background Pneumonia occurring in residents of long-term care facilities and nursing homes can be termed 'nursing home-acquired pneumonia' (NHAP). NHAP is the leading cause mortality among residents. may caused by aspiration oropharyngeal flora into lung, failure individual's defence mechanisms to eliminate aspirated bacteria. Oral measures remove or disrupt oral plaque might effective reducing risk NHAP. Objectives To assess effects for preventing pneumonia other facilities. Search methods Cochrane Health's Information Specialist searched following databases: Cochrane Trials Register (to 15 November 2017), Central Controlled (CENTRAL) (the Library, 2017, Issue 10), MEDLINE Ovid (1946 Embase (1980 2017) Cumulative Index Nursing Allied Health Literature (CINAHL; 1937 2017). The US National Institutes Registry (ClinicalTrials.gov) World Organization International Clinical Platform were ongoing trials. No restrictions placed on language date publication when searching electronic databases. We also Chinese Biomedical Database, China Knowledge Infrastructure, Sciencepaper Online 20 2017. Selection criteria We included randomised controlled trials (RCTs) that evaluated (brushing, swabbing, denture cleaning mouthrinse, combination) any age Data collection analysis At least two review authors independently assessed search results, extracted data, bias studies. contacted study additional information. pooled data from studies with similar interventions outcomes. reported ratio (RR) dichotomous outcomes, mean difference (MD) continuous hazard (HR) time-to-event using random-effects models. Main results four RCTs (3905 participants), all which at high bias. one comparison: professional versus usual care. did not pool (N = 834 was stopped interim due lack a clear between groups. unable determine whether resulted lower incidence rate compared over an 18-month period (hazard 0.65, 95% CI 0.29 1.46; study, 2513 participants analysed; low-quality evidence). number first episodes 24-month (RR 0.61, 0.37 1.01; 366 There evidence reduce pneumonia-associated follow-up 0.41, 0.24 0.72, 507 analysed). uncertain all-cause care, measured 0.55, 0.27 1.15; 141 very Only (834 randomised) adverse interventions. identified no serious events 64 non-serious events, most common cavity disturbances (not defined) dental staining. No Authors' conclusions Although suggests could home this finding must considered caution. Evidence outcomes inconclusive. found high-quality are pneumonia. Further needed draw reliable conclusions.