scholarly journals Additive Effect of Periodontal Disease and Obesity on COVID-19 Outcomes

2021 ◽  
pp. 002203452110296
Author(s):  
H. Larvin ◽  
S. Wilmott ◽  
J. Kang ◽  
V.R. Aggarwal ◽  
S. Pavitt ◽  
...  
Keyword(s):  
Oral Health ◽  
Periodontal Disease ◽  
Hospital Admission ◽  
Odds Ratio ◽  
Admission Rate ◽  
Mortality Rates ◽  
Normal Weight ◽  
Hazard Ratio ◽  
Hospital Admission Rate ◽  
The Impact

This study aims to examine the impact of periodontal disease in obesity on COVID-19 infection and associated outcomes. This retrospective longitudinal study included 58,897 UK Biobank participants tested for COVID-19 between March 2020 and February 2021. Self-reported oral health indicators (bleeding gums, painful gums, and loose teeth) were used as surrogates for periodontal disease. Body fat levels were quantified by body mass index (BMI) and categorized as normal weight (18.5 to 24.9 kg/m2), overweight (25 to 29.9 kg/m2), and obese (≥30 kg/m2). Multivariable logistic regression and Cox proportional hazard models were used to quantify risk of COVID-19 infection, hospital admission, and mortality, adjusted for participants’ demographics and covariates. Of 58,897 participants, 14,466 (24.6%) tested positive for COVID-19 infection. COVID-19 infection was higher for participants who were overweight (odds ratio, 1.18; 95% CI, 1.12 to 1.24) and obese (odds ratio, 1.33; 95% CI, 1.26 to 1.41) as compared with those of normal weight, but infection was not affected by periodontal disease. The hospital admission rate was 57% higher (hazard ratio, 1.57; 95% CI, 1.25 to 1.97) in the obese group with periodontal disease than without periodontal disease, and admission rates increased with BMI category (normal weight, 4.4%; overweight, 6.8%; obese, 10.1%). Mortality rates also increased with BMI category (normal weight, 1.9%; overweight, 3.17%; obese, 4.5%). In addition, for participants with obesity, the mortality rate was much higher (hazard ratio, 3.11; 95% CI, 1.91 to 5.06) in participants with periodontal disease than those without. Obesity is associated with higher hospitalization and mortality rates, and periodontal disease may exacerbate this impact. The results could inform health providers, policy makers, and the general public of the importance to maintain good oral health through seamless provision of dental services and public oral health prevention initiatives.

Impact of the 2009-2014 economic crisis on suicide attempts and self-harm in Portugal

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
V Pinheiro ◽  
B Nunes ◽  
S Pereira da Silva ◽  
C Caetano
Keyword(s):  
Hospital Admission ◽  
Economic Crisis ◽  
Suicide Attempts ◽  
Admission Rate ◽  
Sudden Increase ◽  
Hospital Admission Rate ◽  
Crisis Period ◽  
Increased Risk ◽  
Self Harm ◽  
The Impact

Abstract Background Following the worldwide economic crisis of 2008, studies have found an increased risk for self-harm and suicide attempts, many of which need hospital care. There is no research in Portugal on the matter. Therefore, our goal was to estimate the impact of the Portuguese economic crisis of 2009-2014 on the hospital admission rates by attempted suicide and self-harm in Portugal. Methods A retrospective ecological study, with an interrupted time series analysis of hospital admissions by suicide attempts (data from the national Hospital Mobility Database) in mainland Portugal, between 2003 and 2014, was performed. Resident population data over 15 years old was retrieved from the National Statistics Institute. Poisson regression models were used to compare rates and trends before (2003-2008) and during (2009-2014) the Portuguese economic crisis. All rates were adjusted for seasonality. Results A total of 35,077 hospital admission episodes by suicide attempt were retrieved. The mean admission rate was 2.947 per 100 000 inhabitants per month before the crisis, falling to 2.798 during the crisis period. Before the crisis, the total admission rate was decreasing 1% per year. After the crisis erupted, there was a level change, with a sudden increase of 7.9%. The suicide and self-harm admission rate, after 2008, was constant and approximately 38.8% higher than expected if the earlier trend had continued. Conclusions There was an increase in the total hospital admission rate by suicide attempts and self-harm during the economic crisis period in Portugal, when compared to the previous period. Key messages Economic crisis can pose considerable suicide risks. Urgent action is needed to prevent economic crisis leading to additional suicides.

scholarly journals Hospital admission and mortality rates for non-covid diseases in Denmark during covid-19 pandemic: nationwide population based cohort study

BMJ ◽  
2021 ◽  
pp. n1135
Author(s):  
Jacob Bodilsen ◽  
Peter Brønnum Nielsen ◽  
Mette Søgaard ◽  
Michael Dalager-Pedersen ◽  
Lasse Ole Zacho Speiser ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Hospital Admission ◽  
Respiratory Diseases ◽  
Hospital Admissions ◽  
Admission Rate ◽  
Mortality Rates ◽  
Baseline Period ◽  
Population Based ◽  
Hospital Admission Rate ◽  
Rate Ratios

AbstractObjectiveTo determine the incidence of hospital admissions and associated mortality rates for non-covid medical conditions during the covid-19 pandemic.DesignNationwide, population based cohort study.SettingDenmark from 13 March 2019 to 27 January 2021.ParticipantsAll Danish residents >1 year of age.Main outcomes measuresPopulation based healthcare registries that encompass the entire Danish population were used to compare hospital admission and mortality rates during the covid-19 pandemic (from 11 March 2020 to 27 January 2021) with the prepandemic baseline data (from 13 March 2019 to 10 March 2020). Hospital admissions were categorised as covid-19 when patients were assigned a diagnosis code for covid-19 within five days of admission. All patients were followed until migration, death, or end of follow-up, whichever came first. Rate ratios for hospital admissions were computed using Poisson regression and were directly standardised using the Danish population on 1 January 2019 as reference. 30 day mortality rate ratios were examined by Cox regression, adjusted for age and sex, and covid-19 diagnosis was used as a competing risk.Results5 753 179 residents were identified during 567.8 million person weeks of observation, with 1 113 705 hospital admissions among 675 447 people. Compared with the prepandemic baseline period (mean hospital admission rate 204.1 per 100 000/week), the overall hospital admission rate for non-covid-19 conditions decreased to 142.8 per 100 000/week (rate ratio 0.70, 95% confidence interval 0.66 to 0.74) after the first national lockdown, followed by a gradual return to baseline levels until the second national lockdown when it decreased to 158.3 per 100 000/week (0.78, 0.73 to 0.82). This pattern was mirrored for most major diagnosis groups except for non-covid-19 respiratory diseases, nervous system diseases, cancer, heart failure, sepsis, and non-covid-19 respiratory infections, which remained lower throughout the study period. Overall 30 day mortality rates were higher during the first national lockdown (mortality rate ratio 1.28, 95% confidence interval 1.23 to 1.32) and the second national lockdown (1.20, 1.16 to 1.24), and these results were similar across most major diagnosis groups. For non-covid-19 respiratory diseases, cancer, pneumonia, and sepsis, the 30 day mortality rate ratios were also higher between lockdown periods.ConclusionsHospital admissions for all major non-covid-19 disease groups decreased during national lockdowns compared with the prepandemic baseline period. Additionally, mortality rates were higher overall and for patients admitted to hospital with conditions such as respiratory diseases, cancer, pneumonia, and sepsis. Increased attention towards management of serious non-covid-19 medical conditions is warranted.

scholarly journals Association of a Remote Patient Monitoring (RPM) Program With Reduced Hospitalizations in Cancer Patients With COVID-19

2021 ◽  
pp. OP.21.00307
Author(s):  
Joshua C. Pritchett ◽  
Bijan J. Borah ◽  
Aakash P. Desai ◽  
Zhuoer Xie ◽  
Antoine N. Saliba ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Cancer Patients ◽  
Acute Care ◽  
Patient Monitoring ◽  
Statistical Significance ◽  
Admission Rate ◽  
Remote Patient Monitoring ◽  
Hospital Admission Rate ◽  
Remote Patient ◽  
The Impact

PURPOSE: The goal of this study was to assess the impact of an interdisciplinary remote patient monitoring (RPM) program on clinical outcomes and acute care utilization in cancer patients with COVID-19. METHODS: This is a cross-sectional analysis following a prospective observational study performed at Mayo Clinic Cancer Center. Adult patients receiving cancer-directed therapy or in recent remission on active surveillance with polymerase chain reaction–confirmed SARS-CoV-2 infection between March 18 and July 31, 2020, were included. RPM was composed of in-home technology to assess symptoms and physiologic data with centralized nursing and physician oversight. RESULTS: During the study timeframe, 224 patients with cancer were diagnosed with COVID-19. Of the 187 patients (83%) initially managed in the outpatient setting, those who did not receive RPM were significantly more likely to experience hospitalization than those receiving RPM. Following balancing of patient characteristics by inverse propensity score weighting, rates of hospitalization for RPM and non-RPM patients were 2.8% and 13%, respectively, implying that the use of RPM was associated with a 78% relative risk reduction in hospital admission rate (95% CI, 54 to 102; P = .002). Furthermore, when hospitalized, these patients experienced a shorter length of stay and fewer prolonged hospitalizations, intensive care unit admissions, and deaths, although these trends did not reach statistical significance. CONCLUSION: The use of RPM and a centralized virtual care team was associated with a reduction in hospital admission rate and lower overall acute care resource utilization among cancer patients with COVID-19.

scholarly journals Relationship between dental and periodontal health status and the salivary microbiome: bacterial diversity, co-occurrence networks and predictive models

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
M. Relvas ◽  
A. Regueira-Iglesias ◽  
C. Balsa-Castro ◽  
F. Salazar ◽  
J. J. Pacheco ◽  
...  
Keyword(s):  
Oral Health ◽  
Periodontal Disease ◽  
Bacterial Diversity ◽  
Predictive Models ◽  
Oral Disease ◽  
Rrna Gene ◽  
Convenience Sample ◽  
Core Microbiome ◽  
Rdna Sequencing ◽  
The Impact

AbstractThe present study used 16S rRNA gene amplicon sequencing to assess the impact on salivary microbiome of different grades of dental and periodontal disease and the combination of both (hereinafter referred to as oral disease), in terms of bacterial diversity, co-occurrence network patterns and predictive models. Our scale of overall oral health was used to produce a convenience sample of 81 patients from 270 who were initially recruited. Saliva samples were collected from each participant. Sequencing was performed in Illumina MiSeq with 2 × 300 bp reads, while the raw reads were processed according to the Mothur pipeline. The statistical analysis of the 16S rDNA sequencing data at the species level was conducted using the phyloseq, DESeq2, Microbiome, SpiecEasi, igraph, MixOmics packages. The simultaneous presence of dental and periodontal pathology has a potentiating effect on the richness and diversity of the salivary microbiota. The structure of the bacterial community in oral health differs from that present in dental, periodontal or oral disease, especially in high grades. Supragingival dental parameters influence the microbiota’s abundance more than subgingival periodontal parameters, with the former making a greater contribution to the impact that oral health has on the salivary microbiome. The possible keystone OTUs are different in the oral health and disease, and even these vary between dental and periodontal disease: half of them belongs to the core microbiome and are independent of the abundance parameters. The salivary microbiome, involving a considerable number of OTUs, shows an excellent discriminatory potential for distinguishing different grades of dental, periodontal or oral disease; considering the number of predictive OTUs, the best model is that which predicts the combined dental and periodontal status.

scholarly journals Can dedicated emergency team and area for older people reduce the hospital admission rate? - An observational pre- and post-intervention study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jenny Liu ◽  
Therese Palmgren ◽  
Sari Ponzer ◽  
Italo Masiello ◽  
Nasim Farrokhnia
Keyword(s):  
Length Of Stay ◽  
Hospital Admission ◽  
Older Patients ◽  
Outcome Measure ◽  
Admission Rate ◽  
Intervention Period ◽  
Total Hospital ◽  
Hospital Admission Rate ◽  
Emergency Team ◽  
Interprofessional Team

Abstract Background Emergency department (ED) care of older patients is often complex. Geriatric ED guidelines can help to meet this challenge. However, training requirements, the use of time-consuming tools for comprehensive geriatric assessment (CGA), a lack of golden standard to identify the frail patients, and the weak evidence of positive outcomes of using CGA in EDs pose barriers to introduce the guidelines. Dedicating an interprofessional team of regular ED medical and nursing staff and an older-friendly ED area can be another approach. Previous studies of geriatrician-led CGA in EDs have reported a reduced hospital admission rate. The aim of this study was to investigate whether a dedicated interprofessional emergency team also can reduce the hospital admission rate without the resources required by the formal use of CGA. Methods An observational pre-post study at a large adult ED, where all patients 80 years or older arriving on weekdays in the intervention period from 2016.09.26 to 2016.11.28 and the corresponding weekdays in the previous year from 2015.09.28 to 2015.11.30 were included. In the intervention period, older patients either received care in the geriatric module by the dedicated team or in the regular team modules for patients of mixed ages. In 2015, all patients received care in regular team modules. The primary outcome measure was the total hospital admission rate and the ED length of stay was the secondary outcome measure. Results We included 2377 arrivals in the intervention period, when 26.7% (N = 634) received care in the geriatric module, and 2207 arrivals in the 2015 period. The total hospital admission rate was 61.7% (N = 1466/2377) in the intervention period compared to 64.8% (N = 1431/2207) in 2015 (p = 0.03). The difference was larger for patients treated in the geriatric module, 51.1% compared to 62.1% (95% CI: 56.3 to 68.0%) for patients who would have been eligible in 2015. The ED length of stay was longer in the intervention period. Conclusions An interprofessional team and area dedicated to older patients was associated to a lower hospital admission rate. Further studies are needed to confirm the results.

scholarly journals Restoration of oral health as one of the important factors improving the quality of life

2021 ◽  
Vol 105 (1) ◽  
pp. 78-81
Author(s):  
N. Zhachko ◽  
◽  
T. Nespriad’ko-Monborgne ◽  
I. Skrypnyk ◽  
M. Zhachko ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Periodontal Disease ◽  
Dental Health ◽  
Adult Population ◽  
Communication Process ◽  
Complete Analysis ◽  
Comprehensive Treatment ◽  
The Impact

Summary: The search for and development of methods for determining the quality of life is an urgent problem of foreign and domestic medicine, and the state of dental health plays a very important role. An important role in human communication plays the maxillofacial area. Therefore, the most important areas and defects associated with the communication process – defects in the frontal area, smile, change of pronunciation, spitting during the conversation – all these signs accompany a number of anomalous processes. Objective: to assess the impact of dental status on the quality of life of the adult population in the presence of the disease periodontal disease in combination with musculoskeletal dysfunction in patients with dental anomalies and deformities. Materials and methods. To study this goal, a survey of 283 patients who applied was conducte with complaints of aesthetic defect of the dentition, combined with the presence of joint pain and periodontal disease of varying severity. Results. A complete analysis of factors that significantly affected the quality of life of patients with a number of diseases was obtained oral cavity. Conclusions. Deficiencies related to oral health reduce the quality of life of our patients, and the treatment significantly changes its quality depending on age, sex and method. But for the best results positive changes in the quality of life of the patient dentists can expect only by conducting a comprehensive treatment. Key words: quality of life, dental health correction.

scholarly journals Impact of Periodontal Disease on the Quality of Life of Older People in Indonesia: A Qualitative Study

2021 ◽  
pp. 238008442110419
Author(s):  
M. Hijryana ◽  
M. MacDougall ◽  
N. Ariani ◽  
L.S. Kusdhany ◽  
A.W.G. Walls
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Environmental Factors ◽  
Periodontal Disease ◽  
Older People ◽  
Structured Interviews ◽  
Research Perspective ◽  
The Impact ◽  
People’S Perceptions

Introduction: The impact of periodontal disease on oral health–related quality of life (OHRQoL) has often been investigated from a quantitative research perspective, which is based on clinical findings and an OHRQoL questionnaire. Very few studies have examined the issue from the view of qualitative research. To our knowledge, there have been no previous qualitative studies focusing the effect of periodontal disease on OHRQoL in Indonesian older people. Objectives: To explore and understand the impact of periodontal disease on the OHRQoL of older people as a subjective reflection in relation to periodontal disease experiences. Methods: Semi-structured interviews were conducted in a sample of 31 older people with generalized chronic periodontitis. Thematic analysis was used to identify the key issues in participants’ accounts. The analysis was undertaken by 2 independent coders to ensure reliability. To achieve thematic saturation, successive interviews were undertaken until 5 sequential interviews did not bring new themes. Results: Participants reported the negative effects likely related to periodontal disease. The impacts of periodontal disease were described by these older people as affecting more than pain, physical discomfort, and physical function restrictions. Periodontal disease also affected their psychological and social aspects of daily living. In addition, this study identified themes related to individual and environmental factors that may modify and personalize periodontal disease experiences. Furthermore, this study identified a misleading belief that problems related to periodontal disease were a normal part of aging, which might influence individuals’ expectations toward oral health. Relatedly, participants frequently reported that the progression of tooth mobility to tooth loss was an inevitable part of the aging process. Conclusions: Periodontal disease negatively affected participants’ OHRQoL. It is fundamental to understand older people’s perceptions toward their periodontal disease as well as individual and environmental factors that may have an influence on their periodontal disease experiences. Knowledge Transfer Statement: This study is a reflection of Indonesian older people’s subjective periodontal disease experiences. Therefore, the present study can be used to understand older people’s perceptions, attitudes, behaviors, and experiences toward periodontal disease and how this disease may affect their quality of life. This study also highlights a widespread and misleading belief that oral problems related to periodontal disease are an inevitable part of aging in this study population.

scholarly journals Management of bio-psycho-social frailty to reduce hospital use and improve survival of older adults

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G Liotta ◽  
N Accarino ◽  
S Orlando ◽  
S Gentili ◽  
E Terracciano ◽  
...  
Keyword(s):  
Public Health ◽  
Older Adults ◽  
Health Outcomes ◽  
Social Isolation ◽  
Hospital Care ◽  
Admission Rate ◽  
Term Care ◽  
Hospital Admission Rate ◽  
Starting Point ◽  
The Impact

Abstract Background Ageing of population is associated to the increase of care demand. Many health systems are still centered on hospital care, that sometime is not appropriate. The shift from hospital to community care requires a new model of service delivery. Aim of this paper is to assess the impact of a community service based on the assessment of frailty, on mortality and use of hospital care by older adults. Methods A cohort made up by 8,592 over-75 subjects (67.1% female, mean age 84.5; SD ± 5.29) has been assessed once a year for bio-psycho-social frailty by the administration of the Short Functional Geriatric Evaluation questionnaire. The enrolled subjects were involved in a Community-based pro-Active Monitoring Program which provides interventions aimed at reducing social isolation. Mortality, use of hospital care and use of residential long-term care have been recorded during the follow up and separate and cumulative incidence rate was measured. Results The sample was stratified in Robust (37.5%), Pre-frail (24.0%), Frail, (29.5%) and Very Frail (9.1%) individuals. Mortality, Hospital admission rate and Residential LTC admission rate were higher in the very frails than among the other groups. However, according to social isolation, the integrated subjects at the baseline assessment, showed the highest incidence of negative events: 29.5%, 20.8%, 21.0%, .and 20.8% for integrated, mild isolated, moderate isolated and severely isolated individuals respectively (p < 0.001). The logistic regression analysis, adjusted for age, gender and level of frailty, confirmed the protective role of reducing social isolation among isolated individuals compared with integrated ones (OR: 0.729; CL95% 0.673-0.720). Conclusions The assessment of bio-psycho-social frailty could be the starting point for effective intervention at community level, like the program mentioned above. Management of frailty may lead to an improvement of public health outcomes. Key messages Intervention dealing with social isolation are able to revert the increase of mortality related to the lack of social resources. Management of frailty may lead to an improvement of public health outcomes.

scholarly journals Interdental Cleaning and Oral Health Status in an Adult Cohort, 2015 to 2018

2020 ◽  
Vol 99 (10) ◽  
pp. 1150-1156
Author(s):  
B.W. Chaffee ◽  
D. Persai ◽  
M.V. Vora
Keyword(s):  
Oral Health ◽  
Periodontal Disease ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Disease Risk ◽  
The United States ◽  
Oral Health Status ◽  
Oral Disease ◽  
Health Study ◽  
Lower Odds

Interdental cleaning is routinely recommended, despite limited evidence supporting efficacy to prevent advanced oral disease endpoints, such as caries and periodontal disease. We aimed to examine associations between interdental cleaning and oral health in a large, generalizable prospective cohort of adults in the United States. Data were drawn from wave 3 (2015 to 2016, n = 26,086 included in analysis) and wave 4 (2016 to 2018, n = 22,585) of the adult component (age ≥18 y) of the nationally representative Population Assessment of Tobacco and Health Study. Survey-weighted multivariable regression models estimated the associations between wave 3 weekly interdental cleaning frequency and 6 measures of self-reported oral health—overall rating, tooth extractions, gum bleeding, loose teeth, bone loss around teeth, and gum disease—cross-sectionally and prospectively, with adjustment for established periodontal disease risk factors. As compared with no interdental cleaning, interdental cleaning ≥7 times/wk was prospectively associated with greater odds of excellent self-rated oral health (adjusted odds ratio, 1.37; 95% CI, 1.17 to 1.62), lower odds of bleeding gums (adjusted odds ratio, 0.62; 95% CI, 0.54 to 0.70), but not statistically significantly lower odds of other oral health conditions in the following 12 mo. Older age, lower socioeconomic status, diabetes, and cigarette smoking were consistently associated with worse oral health across all outcome measures. Findings were largely robust to alternative model and variable specifications. Interdental cleaning is associated with better perceived oral health and less self-reported gingivitis. Prevention of more advanced disease states was not demonstrated. These findings should be interpreted cautiously given the self-reported nature of the measures and relatively short follow-up period.

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