Protection of silent aspiration in the elderly

为了研究端脑梗塞的位置与肺炎发病率之间的可能关系，我们回顾评估了276名65岁或以上入住长期护理机构的患者中与肺炎相关的中枢神经系统发病率。对参与这项研究的患者进行监测，以确定他们是否患有影响端脑结构的疾病。所有患者的平均观察时间为22个月，并对中风患者进行了一年以上的随访。单侧基底节梗死组肺炎发生率(27.4%)是其他组的2.66倍，双侧基底节梗死组肺炎发生率(47.0%；0.001)是其他组(10.3%)的4.56倍。由于基底节梗塞患者也有吞咽反射延迟，睡眠中静默吸入的发生率较高，我们推测基底节卒中可能使这些患者由于睡眠中频繁吸入而易患肺炎。

To examine the possible relationship between the location of telencephalic infarctions and the incidence of pneumonia, we retrospectively assessed central nervous system morbidity associated with pneumonia in 276 patients 65 years of age or older admitted to a long-term care facility. Patients involved in this study were monitored to determine if they sustained an affecting telencephalic structures. The average duration of observation for all patients was 22 months, and stroke patients were followed for over one year. The incidence of pneumonia was 2.66 times higher in patients with unilateral basal ganglia infarcts (27.4% ; p<0.01) and 4.56 times higher in patients with bilateral basal ganglia strokes (47.0% ; p<0.001) compared to all the other patient groups combined (10.3%). Since patients with basal ganglia infarcts also had a delayd swallowing reflex associated with a higher incidence of silent aspiration during sleep, we speculate that basal ganglia strokes might predispose these patients to develop pneumonia due to frequent aspiration during sleep.