Predictors for achieving oral intake in older patients with aspiration pneumonia: Videofluoroscopic evaluation of swallowing function
Predictors for achieving oral intake in older patients with aspiration pneumonia: Videofluoroscopic evaluation of swallowing function
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DOI：
10.1111/ggi.13514
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发表时间：
2018-10-01
影响因子：
3.3
通讯作者：
Liu, Meigen
中科院分区：
文献类型：
--
作者：
Ito, Mari;Kawakami, Michiyuki;Liu, Meigen
目的：肺炎是一种常见的疾病，往往是致命的，特别是在老年人。已知吞咽困难与吸入性肺炎密切相关，吸入性肺炎住院患者通常难以口服。然而，口腔摄入量和详细的吞咽数据之间的关系尚未探讨。本研究的目的是检查的预测因素，包括视频透视吞咽评价，实现口服摄入的老年患者吸入性pneumonia.Methods：本研究包括老年患者，年龄≥ 65岁，谁被收住到川崎市立医院（川崎，日本）从2012年4月至2014年3月，由于吸入性肺炎。从病历中提取可能与口服摄入相关的因素，包括吞咽、营养、代谢和功能状态、肺炎严重程度和合并症。多元Logistic回归分析，以确定独立的预测因素收购的oral intake.Results：共160例患者被分配到“口服摄入”组（n=104）或“非口服摄入”组（n=56）。多元回归分析显示，使用倾斜30-60度的3 mL中等粘稠液体水进行视频透视的低渗透抽吸量表、高白蛋白值、非经口摄入持续时间短以及入院前食物摄入水平量表评分高与经口摄入的实现显著相关。电视透视下的误吸、入院前的吞咽状态、营养状况和非经口进食的持续时间是获得经口进食的重要因素。这些结果可能有助于老年吸入性肺炎患者的管理。
Aim: Pneumonia is a common disease that is often fatal, particularly in older persons. Dysphagia is known to be closely associated with aspiration pneumonia, and hospitalized patients with aspiration pneumonia often have difficulty with oral intake. However, the relationship between acquisition of oral intake and detailed swallowing data has not been explored. The purpose of the present study was to examine the predictors, including videofluoroscopic swallowing evaluation, for achieving oral intake in older patients with aspiration pneumonia.Methods: This study included older patients, aged >= 65 years, who were admitted to Kawasaki Municipal Hospital (Kawasaki, Japan) from April 2012 through March 2014 as a result of aspiration pneumonia. Factors likely related to oral intake, including swallowing, nutritional, metabolic, and functional status, pneumonia severity and comorbidities were extracted from the medical records. Multiple logistic regression analysis was carried out to identify independent predictors for acquisition of oral intake.Results: A total of 160 patients were assigned to either the "oral intake" group (n=104) or the "non-oral intake" group (n=56). Multiple regression analysis showed that a low penetration aspiration scale on videofluoroscopy using 3 mL of moderately thick liquid water with tilting 30-60 degrees, high albumin values, short duration of non-oral intake and a high Food Intake Level Scale score before admission were significantly associated with achievement of oral intake.Conclusions: Aspiration on videofluoroscopy, swallowing status before admission, nutritional status and duration of non-oral intake are important factors for acquiring oral intake. These results might be helpful for the management of older patients with aspiration pneumonia.