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Introduction Patients with stroke often experience pneumonia during the acute stage after stroke onset. Oral care may be effective in reducing the risk of stroke‐associated pneumonia (SAP). We aimed to determine the changes in oral care, as well as the incidence of SAP, in patients with intracerebral hemorrhage, following implementation of a learning health system in our hospital. Methods We retrospectively analyzed the data of 1716 patients with intracerebral hemorrhage who were hospitalized at a single stroke center in Japan between January 2012 and December 2018. Data were stratified on the basis of three periods of evolving oral care: period A, during which conventional, empirically driven oral care was provided (n = 725); period B, during which standardized oral care was introduced, with SAP prophylaxis based on known risk factors (n = 469); and period C, during which oral care was risk‐appropriate based on learning health system data (n = 522). Logistic regression analysis was performed to evaluate associations between each of the three treatment approaches and the risk of SAP. Results Among the included patients, the mean age was 71.3 ± 13.6 years; 52.6% of patients were men. During the course of each period, the frequency of oral care within 24 hours of admission increased (P

急性血液浄化において治療前に重症度スコアを算出し，患者の予後を推測することは治療選択や医療資源の有効利用の点から非常に重要であり，患者家族へのインフォームドコンセント（IC）にも有用と思われる．今回われわれは2005年12月から2006年5月までの6か月間で緊急透析の依頼をうけた症例28例を生存群14例と死亡群14例に分け，APACHEIIスコア，SOFA，MODS，日本救命医療学会臓器障害度指数（以後，救命指数と略す）の4つを用いて評価し，予後判定の精度や有用性，経済性について検討した．その結果，APACHEIIスコアより算出された院内予測死亡率においては生存率と死亡率の間で有意差を認めず，SOFAが9点以下，MODSが5点以下，救命指数が6点以下の10例で生存率100％であった．また，単独のスコアでは救命指数が予後を最も正確に反映する重症度スコアであると思われた．急性血液浄化療法は多臓器不全や重症患者において有効な治療法であるが，その反面，他の治療法と比較して1回あたりの費用も非常に高く医療コストもかかるため，適応は科学的根拠に基づいてより厳選すべきであると思われる．