RISK FACTORS FOR THE APPEARANCE OF ORAL CHANGES IN PATIENTS IN THE ICU: A COHORT STUDY
Intensive Care Units; Risk Factors; Diagnosis, Oral;
Introduction: The intensive care unit (ICU) is a sector of the hospital area in which care is provided to patients in critical condition, which generally presents oral changes that affect them in a systemic way. The diagnosis of these changes and the identification of risk factors will contribute to the improvement of health care and the prevention of systemic health problems. Objective: We aim to evaluate the risk factors for the development of oral alterations in patients seen in the Intensive Care Unit. Materials and methods: This is a prospective cohort field study carried out between May and December/2019 with 43 patients in the ICU of the League Against Cancer/RN. The data were collected, after performing an in-lux calibration, by 03 evaluators that included the main outcomes (oral alterations with greater morbidity) and data related to patients (sex, age, length of hospital stay, discharge or death, underlying diseases, condition respiratory and hematological exams). Kappa, Mann Whitney (U), Pearson's Chi-square tests with continuity correction and Fisher's Exact Test were performed. In all tests the value of p = 0.05 was adopted. Results: Among the 43 patients included, 53.5% (n = 23) were female with an average age of 59.8 years (SD ± 17.4). In relation to the groups, the average age of the group that presented oral alterations (66.9 years) was higher than the group without alterations (52.3 years), in addition to longer hospital stay (15.3 days) and higher levels of C-reactive protein. The prevalence of these changes in patients admitted to the ICU was 51.2% (95% CI: 35.6% -66.8%). Among patients with oral changes (n = 22), hyposalivation (n = 9) and tongue coating (n = 9) were the most common. It was observed that male patients (p = 0.02), older than 60 years (p = 0.004) and who use mechanical ventilation (p <0.05) were the risk factors for the development of oral lesions. In addition, the non-parametric U test revealed a statistically significant difference between the groups (presence or absence of changes) in relation to the median age (p <0.01). Conclusions: Age and sex are important risk factors for the development of oral disorders. The use of the orotracheal tube and mechanical ventilation throughout hospitalization should also be considered. In addition, due to the fact that more than 50% of hospitalized patients present changes, it is important to have the DC in full for the prevention, diagnosis and treatment of oral problems. From this, the intensive care team, especially the dentist, must be aware of these risk factors so that individual oral care is performed and health is optimized.