Abstract / Summary
Children often experience psychological distress after cardiac surgery, but whether oral hygiene status is related to such disorders remains unknown. We explored the potential association between daily oral care and symptoms of anxiety and depression after cardiac surgery in children with congenital heart disease (CHD). We extracted data from 156 pediatric patients who were transferred to the ICU after cardiac surgery between January 2008 and December 2023. Daily oral care with 2% chlorhexidine was provided to a subset of patients according to clinical indication (reduced consciousness, mechanical ventilation, or inability to self-care); those who did not receive nurse-administered oral care served as the control group. The association between oral care and psychological scores (Children’s Depression Inventory [CDI] and Screen for Child Anxiety-Related Emotional Disorders [SCARED]) was evaluated using multivariable linear and logistic regression analyses, adjusted for age, sex, mechanical ventilation, and ICU length of stay. The mean CDI and SCARED scores were 23.4 and 27.2, respectively, in the oral care group. In the fully adjusted model, daily oral care was significantly associated with lower CDI (adjusted coefficient = −0.26, 95% CI −0.50 to −0.10, P <0.01) and SCARED scores (adjusted coefficient = −0.21, 95% CI −0.48 to −0.10, P <0.01). Logistic regression confirmed a reduced risk of depressive (adjusted OR = 0.83, 95% CI 0.73–0.93, P =0.024) and anxiety states (adjusted OR = 0.81, 95% CI 0.71–0.90, P =0.020). Subgroup analysis showed that the effect was stronger in patients with poor baseline oral hygiene (BOAS score ≥6). Daily oral care was significantly associated with lower risks of anxiety and depression in children after cardiac surgery. This provides evidence to support standardized oral care protocols in pediatric cardiac ICUs.