Predictors for achieving oral intake in older patients with aspiration pneumonia: Videofluoroscopic evaluation of swallowing function

Ito, Mari; Kawakami, Michiyuki; Ohara, Emi; Muraoka, Kaori; Liu, Meigen

doi:10.1111/ggi.13514

Cited by 9 publications

(8 citation statements)

References 27 publications

(63 reference statements)

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“…Therefore, our study differs from the previous study in terms of the causative disease of the patients and the timing of the evaluation of the swallowing function. Previous studies limited to aspiration pneumonia have conducted research using big data 4 and VF findings 5 ; however, none of these reports indicated whether their survey items with significant differences were suitable screening tests to predict the prognosis of oral intake status for patients with aspiration pneumonia. Our study is therefore the first to suggest that the Hyodo‐Komagane score may be useful as a screening test for prognostic prediction.…”

Section: Discussionmentioning

confidence: 99%

“…4 Another study using videofluorography (VF) suggested that the penetration-aspiration scale (P-A scale) is useful for predicting whether or not nutrition can be completely taken orally after 4 weeks of VF, indicating the importance of conducting VF and performing nutritional management at an early stage of hospitalisation. 5 However, VF requires large-scale equipment, and it cannot be performed multiple times over a short period because of concerns about the exposure dose. However, videoendoscopic examination of swallowing (VE) requires only relatively simple equipment, and it can be performed multiple times regardless of location.…”

Section: Introductionmentioning

confidence: 99%

“…In a previous study using big data, it was reported that the Barthel index on admission, underweight admission and past history were useful as predictors of the prognosis for oral intake recovery within 30 days after admission for aspiration pneumonia 4 . Another study using videofluorography (VF) suggested that the penetration‐aspiration scale (P‐A scale) is useful for predicting whether or not nutrition can be completely taken orally after 4 weeks of VF, indicating the importance of conducting VF and performing nutritional management at an early stage of hospitalisation 5 . However, VF requires large‐scale equipment, and it cannot be performed multiple times over a short period because of concerns about the exposure dose.…”

Section: Introductionmentioning

confidence: 99%

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Prediction of oral intake recovery for inpatients with aspiration pneumonia by videoendoscopic evaluation using the Hyodo‐Komagane score in Japan

Kimura

Nakayama

Ogawa

et al. 2020

J of Oral Rehabilitation

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Objective: To verify the validity of the prediction of oral intake recovery for inpatients with aspiration pneumonia using the Hyodo-Komagane score. Background: Patients admitted for treatment of aspiration pneumonia sometimes have difficulty in resuming oral intake due to decreased swallowing function. Predicting whether the swallowing function will recover enough to achieve oral ingestion at discharge is an important factor in developing a treatment strategy. No studies have investigated the prediction of oral intake recovery using videoendoscopic examination. Methods: Subjects were 65 patients who were admitted to an acute care hospital for the treatment of aspiration pneumonia. The patients were divided into two groups, the oral feeding group and the tube feeding group, according to their oral intake status at discharge or transfer. Logistic regression analysis was performed using the condition that tube feeding was not required as an objective variable and the items with significant differences between the two groups as explanatory variables. Additionally, the receiver operating characteristic curve was used to identify patients who could take food orally at discharge. Results: The odds ratios for the Hyodo-Komagane score and the pharyngeal clearance score were 1.485 and 3.379, respectively. When the cutoff values of the Hyodo-Komagane score and the pharyngeal clearance score were 6 and 1, the sensitivity was 0.88 and 0.91, and the specificity was 0.64 and 0.70, respectively. Conclusion: The Hyodo-Komagane score and especially the pharyngeal clearance score are useful indices to predict oral intake recovery for inpatients with aspiration pneumonia. K E Y W O R D S aspiration pneumonia, dysphagia, oral intake, oral rehabilitation, predict, videoendoscopic How to cite this article: Kimura M, Nakayama E, Ogawa Y, et al. Prediction of oral intake recovery for inpatients with aspiration pneumonia by videoendoscopic evaluation using the Hyodo-Komagane score in Japan.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prediction of oral intake recovery for inpatients with aspiration pneumonia by videoendoscopic evaluation using the Hyodo‐Komagane score in Japan

Kimura

Nakayama

Ogawa

et al. 2020

J of Oral Rehabilitation

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“…Data on age, sex, underlying disease (cerebrovascular, gastrointestinal, respiratory, circulatory, orthopedic, and other), past medical history, and comorbidities (head and neck tumors, gastroesophageal surgery, cerebrovascular disease, chronic lower respiratory airway disease, diabetes mellitus, and dementia), body mass index (BMI), frequency of use of urinary catheters, frequency of use of proton pump inhibitors and angiotensin-converting enzyme inhibitors, length of hospital stay, time from hospitalization to resuming oral intake, mortality, and swallowing ability (positive dysphagia screening rate, MSS, PAS, and FOIS scores at discharge) were collected from the medical records or from video recordings after referencing earlier studies of factors that may affect oral intake [ 25 – 27 ].…”

Section: Methodsmentioning

confidence: 99%

Temporal characteristics of aspiration pneumonia in elderly inpatients: From resumption of oral intake to onset

et al. 2022

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Background Elderly inpatients who develop fevers after resumption of oral intake are often considered to have aspiration pneumonia (AP) and be tentatively fasted. Fasting has been associated with prolonged hospital stays and decreased swallowing ability. The purpose of this study was to compare AP and other infections after resumption of oral intake in elderly inpatients and to identify the clinical characteristics. Patients and methods The records of patients who were admitted to a public tertiary hospital and referred for evaluation of swallowing disability were retrospectively reviewed to identify those who had developed AP, non-AP, or urinary tract infection (UTI) after resumption of oral intake. Eligible patients were enrolled consecutively in the study. The patient characteristics, physical findings, laboratory data, oral intake status at the time of onset of symptoms, and rate of discontinuation of oral intake after onset of infection were compared between the three types of infection. Results A total of 193 patients developed an infectious illness after resuming oral intake. Among them, 114 patients had a diagnosis of AP (n = 45), non-AP (n = 24), or UTI (n = 45). There were no significant differences in patient characteristics, physical findings or laboratory data between the group with AP and the other two groups. AP developed at a median of 6 (range 1–16) days after resumption of oral intake. The rate of discontinuation of oral intake was 91.1% in the AP group, 58.3% in the non-AP group, and 26.7% in the UTI group, respectively. Conclusion Infectious diseases other than AP should be considered in the differential diagnosis when nosocomial fever develops in elderly inpatients more than 17 days after resuming oral intake. Furthermore, nosocomial fever after resuming oral intake has many causes other than AP, and discontinuation of oral intake should be carefully considered.

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“…36 In non-ventilated patients, the microbiome and the environment is more fluid and subject to dilution effects of saliva, which might negatively impact efficacy. 37,38 It is also possible that the time to onset which defines NVAP reduces the potential prophylactic Heterogeneity: I 2 = 74%, tau 2 = 0.1921, p = 0.05 Table 6 Forest plot of the non-RCTs (enhanced oral care in the prevention of NVAP). Review: enhanced oral hygiene maintenance for the prevention of non-ventilated pneumonia.…”

Section: Other Studiesmentioning

confidence: 99%

Enhanced oral hygiene interventions as a risk mitigation strategy for the prevention of non-ventilator-associated pneumonia: a systematic review and meta-analysis

2020

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Ongoing professional dental care is the most predictably effective preventive intervention for non-ventilated pneumonia (NVAP) for patients in long-term care facilities. Structured oral care may be warranted for hospitalised patients at risk of NVAP. Additional, prospective, randomised, controlled clinical trials are needed to validate the utility of oral care interventions as a preventive strategy for NVAP.

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Predictors for achieving oral intake in older patients with aspiration pneumonia: Videofluoroscopic evaluation of swallowing function

Cited by 9 publications

References 27 publications

Prediction of oral intake recovery for inpatients with aspiration pneumonia by videoendoscopic evaluation using the Hyodo‐Komagane score in Japan

Prediction of oral intake recovery for inpatients with aspiration pneumonia by videoendoscopic evaluation using the Hyodo‐Komagane score in Japan

Temporal characteristics of aspiration pneumonia in elderly inpatients: From resumption of oral intake to onset

Enhanced oral hygiene interventions as a risk mitigation strategy for the prevention of non-ventilator-associated pneumonia: a systematic review and meta-analysis

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