Dados do Resumo

Título

Oral Profile of Oncology Patients in the Intensive Care Unit: A Prospective Observational Study at a Cancer Center

Descrição da inciativa

Oncological patients admitted to the intensive care unit (ICU) usually present critical systemic conditions and may presented serious complications. It is well recognized that microorganisms present in the oral cavity and oropharynx may be transported into the lungs resulting in potential risk of ventilator-associated pneumonia. The literature is scarce regarding oral condition and its impact on the evolution and recovery in this group of patient. The objectives of this study were to evaluate the oral problems presented by oncologic ICU patients and to verify if there is an association with clinical risks factors.

The study was approved by ethics committee (6.322.716) and was a prospective, observational, cross-sectional investigation involving 234 consecutive patients admitted to the ICU due to unplanned hospitalizations. The inclusion criteria include patients over 18 years old, admitted for unplanned reasons, while those in post-surgical recovery are excluded. Upon obtaining patient or guardian consent, the study follows three phases: Phase 1 (within 24 hours of ICU admission), Phase 2 (after 3 days), and Phase 3 (after 5 days). Clinical performance was evaluated using the Eastern Cooperative Oncology Group (ECOG) performance scale and the Charlson Comorbidity Index (CCI).

Impacto e resultados

At each phase, intraoral examinations, oral lesion assessments, salivary pH measurements, and mouth photography were conducted. The Bedside Oral Examination (BOE) index will be used for oral condition assessment, while mucositis was graded using scales from the World Health Organization (WHO) and National Cancer Institute (NCI).

Preliminary data from 102 patients, 63 female and 39 male, were evaluated. The main reasons for ICU admission were septic shock (n=14), hypoxemic respiratory failure (n=17), and sepsis without Shock (n=13). The majority (80.3%) showed intraoral findings during ICU admission. The most frequent findings were crusted lips, coated tongue, pale mucosa, candidiasis, depapillated tongue and traumatic lesions. There were significant higher association in patients with metastatic solid tumors (p=0.041) and thrombocytopenia (p=0.038). Oral findings were frequent in oncology patients hospitalised in the ICU and most of them were associated with worse clinical prognosis. The involvement of a dentist is essential for for the early detection of oral alterations and the clinical management of these patients.

Keywords: Intensive Care Unit, oncology, oral health, mucositis, oral care protocol.