Factors Involved in the Detection and Development of Oral Candidiasis in a Palliative-Care Unit

Abstract

Backgrounds

Oral complications, including candidiasis, commonly impact palliative care patients, significantly diminishing their quality of life. Early detection by palliative care teams is paramount, however, research on multidisciplinary interventions in this setting is limited.

Objectives

To examine the effect of dental hygienist’s ward rounds and the characteristics of patients with oral candidiasis to establish a strategy for early detection.

Design

Retrospective Observational Study.

Setting/Subjects

We conducted a survey of patients admitted to the palliative-care unit of the National Hospital Organization Chiba Medical Center in Japan between April 1, 2019, and March 31, 2022. Patients with a hospital stay ≤7 days were excluded.

Measurements

Data including age, sex, history, renal function test values, and prescribed medications were collected from the electronic medical record system.

Results

A total of 594 patients were included. They were divided into 2 groups based on whether they were admitted before or after the start of the ward rounds. In the pre-intervention group, 3 patients (1.05%) had oral candidiasis, whereas 20 patients (6.5%) had oral candidiasis in the post-intervention group. Furthermore, a multivariate analysis identified long-term systemic steroid use, multiple-route steroid administration, number of steroid components, and a primary cancer site above the diaphragm as factors significantly associated with the development of oral candidiasis.

Conclusion

The participation of dental hygienists in palliative-care units is advantageous for the early detection of oral candidiasis. Complex histories of steroid administration and a cancer site contiguous with the oral cavity should be noted as high-risk factors in palliative-care units.