Factors influencing oral cavity status during high-dose antineoplastic therapy: a secondary data analysis.

PURPOSE/OBJECTIVES: To identify factors associated with oral cavity status in patients receiving high-dose antineoplastic therapy. DESIGN: Descriptive, correlational secondary analysis. SETTING: Midwestern university oncology special care unit. SAMPLE: 50 males and females, ages 15-69. METHODS: The Oral Assessment Guide (OAG) was used to assess oral cavity status every shift throughout hospitalization. Additional data were collected by chart audit. Correlations and Cox regression analysis were performed. MAIN RESEARCH VARIABLES: Oral cavity status, absolute granulocyte count, blood urea nitrogen (BUN), creatinine, mean OAG score during the preparative regimen (prep-OAG), age, and total body irradiation (TBI). FINDINGS: Elevated BUN and creatinine, higher prep-OAG, older age, and TBI were associated with higher OAG scores. Cox analysis revealed that TBI was predictive of an OAG score > or = 16, and an OAG score > or = 18 was predictive of death by day +20. CONCLUSIONS: Patients who receive TBI and chemotherapy in combination are most likely to experience severely compromised oral cavity status. Those who are older, have poorer oral status, and have decreased renal function are at increased risk. IMPLICATIONS FOR NURSING PRACTICE: High-risk patients must be identified early, and oral assessments and care must be given consistently to decrease morbidity and potential mortality.