Evidence map›Paper›PMID 28629318›Full record

Trial reportBMC geriatrics2017

The effect of a daily application of a 0.05% chlorhexidine oral rinse solution on the incidence of aspiration pneumonia in nursing home residents: a multicenter study.

Vanessa R Y Hollaar, Gert-Jan van der Putten, Claar D van der Maarel-Wierink, Ewald M Bronkhorst, Bert J M de Swart, Nico H J Creugers

Open access · goldAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC geriatrics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 3 pooled it
6.1field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 3 syntheses or guidelines pooled it, 35 citations in OpenAlex.

  1. Oral care measures for preventing nursing home-acquired pneumonia.The Cochrane database of systematic reviews · 2022
    Pooled it
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  3. Oral care measures for preventing nursing home-acquired pneumonia.The Cochrane database of systematic reviews · 2018
    Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Vanessa R Y HollaarDepartment of Neurorehabilitation, HAN University of Applied Sciences, P.O. Box 6960, Nijmegen, GL, 6503, The Netherlands. vanessa.hollaar@radboudumc.nl.
Gert-Jan van der PuttenBENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Ghent, Nijmegen, Belgium.
Claar D van der Maarel-WierinkBENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Ghent, Nijmegen, Belgium.
Ewald M BronkhorstDepartment of Preventive and Restorative Dentistry, Radboud University Nijmegen Medical Centre, P.O. Box 9101, Nijmegen, HB, 6500, The Netherlands.
Bert J M de SwartDepartment of Neurorehabilitation, HAN University of Applied Sciences, P.O. Box 6960, Nijmegen, GL, 6503, The Netherlands.
Nico H J CreugersDepartment of Oral Function and Prosthetic Dentistry, Radboud University Nijmegen Medical Centre, P.O. Box 9101, Nijmegen, HB, 6500, The Netherlands.
HAN University of Applied Sciences · NLRadboud University Medical Center · NLRadboud University Nijmegen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDysphagia and potential respiratory pathogens in the oral biofilm are risk factors for aspiration pneumonia in nursing home residents. The aim of the study was to examine if the daily application of 0.05% chlorhexidine oral rinse solution is effective in reducing the incidence of aspiration pneumonia in nursing home residents with dysphagia. Associations between background variables (age, gender, dysphagia severity, care dependency, medication use, number of medical diagnoses, teeth and dental implants, and wearing removable dentures) and the incidence of aspiration pneumonia were also examined.

methodsThis study is a multicenter study in which for 1 year participants with dysphagia in the intervention group received the usual oral hygiene care with the addition of a 0.05% chlorhexidine oral rinse solution, whereas participants in the control group received only oral hygiene care.

resultsData of 103 participants in 17 nursing homes were analyzed. Survival analysis showed no significant difference in the incidence of pneumonia between both groups (Cox regression, HR = 0.800; 95% CI [0.368-1.737], p = 0.572). Cox regression analysis for Functional Oral Intake Scale (FOIS)-level showed a significant risk of the incidence of pneumonia (HR = 0.804; 95% CI [0.656-0.986], p = 0.036). After adjustment for Group and FOIS-level, Cox multivariate proportional hazard regression analysis showed that the variables age, gender, Care-dependency Scale-score (CDS) number of diseases, medication use, number of teeth, and the presence of dental implants or removable dentures were not significantly associated with the incidence of pneumonia.

conclusionsChlorhexidine oral rinse solution 0.05% as an adjunctive intervention in daily oral hygiene care was not found to reduce incidence of aspiration pneumonia. The requested number of participants to achieve sufficient power was not established and high drop-out rate and non-structural compliance was present. The power was considered to be sufficient to analyze the associations between the background variables and the incidence of pneumonia in the included nursing home residents with dysphagia. Dysphagia was found to be a risk factor for aspiration pneumonia.

trial registrationRegistration in The Netherlands National Trial Register: TC = 3515. Approval for the study was obtained from the Medical Ethical Committee of the Radboud University Medical Center (NL. nr:41,990.091.12).

Indexed as

Administration, OralAgedAged, 80 and overAnti-Infective Agents, LocalChlorhexidineDrug Administration ScheduleFemaleHumansIncidenceMaleMouthwashesNetherlandsNursing HomesPharmaceutical SolutionsPneumonia, AspirationRisk FactorsAnti-Infective Agents, LocalChlorhexidineMouthwashesPharmaceutical SolutionsAspiration pneumoniaChlorhexidineDysphagiaNursing homeOral health careOral hygiene carePneumonia

Identifiers

PMID28629318
PMCPMC5477106
OpenAlexW2687590371

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.