Avaliação da condição de saúde oral e sistêmica de pessoas idosas internadas na UTI

• Ano de defesa: 2024
• Autor(a) principal: Haje, Giovanna Louly Caixe El
• Orientador(a): Miranda, Alexandre Franco
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Católica de Brasília
• Programa de Pós-Graduação: Programa Stricto Sensu em Gerontologia
• Departamento: Escola de Saúde e Medicina
• País: Brasil
• Palavras-chave em Português: Unidade de Terapia Intensiva; Idoso fragilizado; Assistência integral à saúde; Saúde bucal; Comorbidade
• Palavras-chave em Inglês: Intensive Care Unit; Fragile elderly; Comprehensive health care; Oral health; Comorbidity
• Área do conhecimento CNPq: CNPQ::CIENCIAS DA SAUDE
• Link de acesso: https://bdtd.ucb.br:8443/jspui/handle/tede/3526

OBJECTIVE: The objective of this work was to evaluate the oral and systemic condition of elderly people admitted to an intensive care unit (ICU). METHOD: Cross-sectional, observational and descriptive study, in which oral and systemic health conditions were evaluated, as well as their relationships. Convenience sample composed of 150 elderly people, aged 60 or over, admitted to an ICU in Brasília. General, systemic and oral health condition data were obtained after clinical evaluation carried out by a single calibrated examiner by comparing the evaluators between 2 specialists in hospital dentistry with a kappa index (0,85). Information from electronic medical records on pre-determined days and times. All conscious participants and legal guardians of other unconscious patients signed the informed consent form. Research project approved by the CEP of the Catholic University of Brasília under CAAE 77304823.9.0000.0029. The data obtained were noted down on individualized sheets, later categorized, and organized in an Excel spreadsheet for statistical analysis divided into two parts: univariate descriptive to understand the patients' profile according to demographic and health characteristics, and bivariate descriptive on the relationships between the presence of tongue coating and comorbidities, hygiene frequency and mechanical ventilation condition, using the Mann-Whitney, Kruskal-Wallis and Dunn test with Bonferroni adjustment with a significance of 5% using R language, through the IDE R Studio. RESULTS: The results were organized into 3 articles.The majority of elderly people evaluated were female (n=78), mean age 75.21 years, conscious (59.3%), without mechanical ventilation support (45.3%), oral feeding ( 64%) and had the help of a caregiver/guardian (66.7%). The main reasons for hospitalization were due to postoperative conditions (30%) and lung problems 28.7%), Systemic Arterial Hypertension was the most prevalent comorbidity (80%) and were under the action of anticoagulants (88.7%). and antibiotics (80.7%). They performed oral hygiene with assistance (71.3%), had mucosal lesions (n= 35), used some type of dental prosthesis (42%), the majority of which were complete upper dentures (n= 25), and had unsatisfactory hygiene ( 57.4%) of the sample. Presence of coating on the back of the tongue (n= 142), average DMFT index of 22.3 (average of 17.65 missing teeth) and unsatisfactory oral hygiene during hospitalization (n= 109). The majority (87.33%) needed some type of dental assistance or treatment: reinforcement of oral hygiene actions (n= 69); immediate intervention associated with pain, trauma and infections (n= 27); supragingival scaling (n= 17) and photobiomodulation (lasertherapy) (n= 23). There was no statistical significance between the relationship between tongue coating and systemic diseases, the closest being associated with heart disease (p=0.1602); frequency of cleaning and presence of tongue coating (p=0.1205). There was a level of significance when analyzing the association between tongue coating and mechanical ventilation in the ICU (p=0.03481). CONCLUSION: The high prevalence of systemic arterial hypertension and the use of anticoagulants characterize a vulnerable group of elderly people in this ICU, requiring multidisciplinary and individualized care. The study reveals that hospitalized elderly people exhibit a significantly compromised oral health profile, indicating the urgency of specific dental interventions during hospitalization. The need to integrate oral health into hospital protocols for the elderly population in the ICU is emphasized, particularly in patients on mechanical ventilation, due to the high risk of complications associated with the accumulation of biofilm and tongue coating.