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Oral clinical findings and intensive care unit prognostic scores
  1. Renata de Moura Cruz Quintanilha1,
  2. Mara Regina Rocha Pereira1,
  3. Silvia Paula de Oliveira2,
  4. Daniela Cia Penoni3,
  5. Diamantino Ribeiro Salgado2,
  6. Michelle Agostini1 and
  7. Sandra R Torres1
  1. 1Department of Oral Pathology and Diagnosis, School of Dentistry, School of Dentistry, Universidade Federal do Rio de Janeiro - Rio de Janeiro, Brazil, Rio de Janeiro, Brazil
  2. 2Clementino Fraga Filho University Hospital, Universidade Federal do Rio de Janeiro- Rio de Janeiro, Brazil, Rio de Janeiro, Brazil
  3. 3Department of Dental Clinic, School of Dentistry, Universidade Federal do Rio de Janeiro - Rio de Janeiro, Brazil, Rio de Janeiro, Brazil
  1. Correspondence to Dr Renata de Moura Cruz Quintanilha, Pathology and oral diagnosis, UFRJ, Rio de Janeiro, Brazil; renatamcruz18{at}


Objective Hospitalisation in intensive care unit (ICU) may cause changes in oral environment, which may influence patients’ health status. The aim of this study was to evaluate the frequency of intraoral and extraoral findings observed during ICU admission, and to verify if there is an association with clinical prognosis scores.

Methods Data regarding clinical characteristics of patients hospitalised in an ICU were collected from medical records. The prognostic scores Sepsis Related Organ Failure Assessment (SOFA) and Simplified Acute Physiology Score (SAPS 3) were estimated with data collected from admission and SOFA on the day of the oral examination as well. Data on oral mucosa lesions, saliva, dental condition and oral hygiene were evaluated during oral examinations.

Results The association of oral findings with prognostic scores was statistically verified. The majority (92.2%) of the 170 evaluated patients showed extraoral or intraoral findings during ICU admission. The most frequent findings were chapped and crusted lips, coated tongue, pale mucosa, haemorrhagic lesions, candidiasis, depapillated tongue and traumatic lesions. There were significant higher prognostic scores in the presence of the following extraoral and intraoral findings: crusted and ulcerated lips, haemorrhagic lesions, jaundice, spontaneous oral bleeding, coated and depapillated tongue. Median SAPS 3 was higher in patients with poor oral hygiene.

Conclusions Oral findings were frequent in the population of patients hospitalised in the ICU and some of them were associated with worse prognostic scores. Routine oral examinations must be performed in hospitalised patients from ICUs for detection of oral markers of worse clinical prognosis.

  • hospital care
  • prognosis
  • supportive care
  • terminal care

Data availability statement

Data are available upon request to Dr. Sandra R. Torres. Email:

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Data availability statement

Data are available upon request to Dr. Sandra R. Torres. Email:

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  • Contributors All authors, Quintanilha, RMC, Pereira, MRR, Penoni, DC, Oliveira, SP, Salgado, DR, Agostini, M e Torres, SR gave significant contributions to the design acquisition, analysis and interpretation of data, to the drafting and revision of the work and final approval of the version to be published. They have agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy of integrity of any part of the work are appropriately investigated and resolved.

    Torres, SR is an author responsible for the overall content as the guarantor. She accepts full responsibility for the work and/or the conduct of the study, had access to the data, and controlled the decision to publish.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.