Examination of factors associated with aspiration pneumonia following stroke

Abstract

a b s t r a c tBackground: Studies have investigated factors related to aspiration pneumonia (AP) onset in stroke patients. However, no study has examined the influence of swallowing function assessment-based strategies. Purpose: The purpose of this study is to investigate factors related to the onset of AP that differ before and after swallowing function assessment. Methods and subjects: Subjects consisted of 143 patients admitted to acute-stage hospitals within 7 days of stroke onset. We examined the association between AP onset within 1 year after stroke and several parameters. Results: AP incidence was 24.5% overall, 20.3% before swallowing function assessment, and 7.7% after assessment. In patients who developed AP prior to swallowing function assessment, the onset was associated with male gender [odds ratio (OR): 6.206, 95% confidence interval (CI): 1.871-28.937], dysarthria (OR: 5.683, CI: 1.432-38.713), and denture usage (OR: 2.843, CI: 1.011-8.048). In those who developed AP after swallowing function assessment, AP was associated with cerebral atrophy (OR: 4.225, CI: 1.071-16.705), infracted foci in the basal ganglia (OR: 8.914, CI: 1.489-77.776), and Barthel Index (BI) <100 points before admission (OR: 5.404, CI: 1.418-21.482). Conclusions: Onset of AP after stroke was associated with gender, dysarthria, denture usage at before swallowing function assessment and cerebral atrophy, infarcted foci in the basal ganglia, and BI before admission at after swallowing function assessment. It is necessary to pay attention to the fact that factors related to AP differ before and after swallowing function assessment to identify patients at high risk of developing AP after stroke.

Japanese clinical practice guidelines for aspiration and pharyngeal residual assessment during eating and swallowing for nursing care

“…As a result, 362 studies were identified and two observational studies were adopted after screening (Oguchi et al, 2000; Watanabe, 2007). The sensitivity and specificity for detecting aspiration by RSST were 0.98 and 0.66, respectively, in a study of 131 patients aged 17 years and older (Oguchi et al, 2000) and 0.69 and 0.40, respectively, in a study of 82 patients aged 58 years and older (Watanabe, 2007). A meta‐analysis was difficult to conduct because only two articles were available.…”

Hubungan Disfagia Dan Penurunan Kesadaran Terhadap Pneumonia Aspirasi Pada Pasien Stroke Rs Atma Jaya

“…7 Pneumonia yang terjadi pada pasien stroke umumnya disebabkan mekanisme aspirasi. 5,[7][8][9] Kecenderungan pasien stroke untuk terkena disfagia dan penurunan kesadaran ditemukan sebagai faktor risiko penting yang mempermudah terjadinya aspirasi. 7,[10][11][12][13] Prevalensi pasien stroke yang terkena disfagia berkisar antara 28-65%, sedangkan yang mengalami penurunan kesadaran antara 4-38%.…”

“…Hal ini terjadi akibat kombinasi penurunan daya tahan tubuh yang disebabkan oleh penyakit stroke sendiri, ditambah terganggunya fungsi dan koordinasi menelan akibat cedera neurologis yang meningkatkan kemungkinan aspirasi, seperti disfagia dan penurunan kesadaran. [5][6][7][8][9][10][11][12][13]17 Dominasi laki-laki sesuai dengan penelitian Wandira dkk, Ganz dkk, dan Poorthuis dkk, bahwa stroke lebih sering pada laki-laki dibandingkan perempuan. Hal ini berhubungan dengan multi faktor seperti genetik, efek protektif estrogen pada sirkulasi serebral perempuan, serta tingginya angka prevalensi hipertensi, penyakit jantung iskemik, dan merokok pada laki-laki.…”

Factors associated with bronchopulmonary aspiration: a national-based study

“…Furthermore, although studies have been published internationally on risk factors for bronchopulmonary aspiration, most were conducted in a single healthcare institution and included a specific group of patients (6,(11)(12) . Furthermore, the factors associated with death from bronchopulmonary aspiration have not been fully elucidated, especially in the national scenario.…”