Pneumonia: dental care cuts recurrence risk for neurologically impaired children

  • Lin JL & al.
  • Pediatrics
  • 19 Sep 2019

  • International Clinical Digest
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Takeaway

  • Neurologically impaired children with a pneumonia hospitalisation were 36% less likely to experience another if they received dental care.
  • Of 8 expert-recommended pneumonia prevention strategies, dental care was the only one to significantly reduce risk.

Why this matters

  • High susceptibility of this population to pneumonia.

 Key results

  • 37.5% of the cohort had a subsequent pneumonia hospitalisation.
  • Receipt of 8 pneumonia prevention strategies varied:
    • Most common: clinic visit after discharge from index hospitalisation (77%).
    • Least common: chest physiotherapy (5%).
  • Dental care, received by 20%, was the only strategy independently associated with reduced risk for subsequent pneumonia hospitalisation (aOR, 0.64; 95% CI, 0.49-0.85).
  • Strategies independently associated with increased risk:
    • Gastrostomy tube placement (aOR, 2.15; 95% CI, 1.63-2.85).
    • Chest physiotherapy (aOR, 2.03; 95% CI, 1.29-3.20).
    • Outpatient antibiotics before index hospitalisation (aOR, 1.42; 95% CI, 1.06-1.92).
    • Clinic visit before index hospitalisation (aOR, 1.30; 95% CI, 1.11-1.52).
    • Clinic visit after index hospitalisation (aOR, 1.72; 95% CI, 1.35-2.20).

Study design

  • Retrospective cohort study with propensity matching of 3632 children (aged 0-21 years) enrolled in California Children’s Services July 2009-June 2014, having neurologic impairment and a pneumonia hospitalisation.
  • Main outcome: subsequent pneumonia hospitalisation.
  • Funding: National Institutes of Health.

Limitations

  • Possible residual confounding by indication.
  • Potential misclassification.

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