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Published in: Dysphagia 3/2022

01-06-2022 | Aspiration Pneumonia | Original Article

Relationships Between Survival and Oral Status, Swallowing Function, and Oral Intake Level in Older Patients with Aspiration Pneumonia

Authors: Taku Suzuki, Takanori Tsujimura, Jin Magara, Naohito Hao, Naru Shiraishi, Kazuya Maekawa, Kazuo Matsushima, Makoto Inoue

Published in: Dysphagia | Issue 3/2022

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Abstract

The factors affecting the survival of patients with aspiration pneumonia (AP) remain unclear. This study aimed to determine whether factors, including oral status, swallowing function, and oral intake level, were related to survival outcomes in older patients hospitalized for AP. The study enrolled patients with AP who were admitted to our hospital between February 2017 and November 2019. Patients were divided into two groups based on the 90-day mortality after the first swallowing function evaluation: survivors and deceased. The data were compared between the two groups. A total of 29 patients were diagnosed with AP. Of these patients, 13 died within 90 days. The numbers of patients who could not use removable dentures and required sputum suctioning and had cough reflex at rest were significantly higher in the deceased than in the survivors. The salivary pooling and pharyngeal clearance scores evaluated by videoendoscopy, International Dysphagia Diet Standardisation Initiative Functional Diet Scale score determined after swallowing function evaluation, and consciousness level were significantly worse in the deceased than in the survivors. There were significant differences in patients’ oral status, swallowing function, oral intake level, and consciousness level between the survivors and deceased.
Literature
2.
go back to reference Teramoto S, Fukuchi Y, Sasaki H, Sato K, Sekizawa K, Matsuse T. High incidence of aspiration pneumonia in community- and hospital-acquired pneumonia in hospitalized patients: a multicenter, prospective study in Japan. J Am Geriatr Soc. 2008;56:577–9.CrossRef Teramoto S, Fukuchi Y, Sasaki H, Sato K, Sekizawa K, Matsuse T. High incidence of aspiration pneumonia in community- and hospital-acquired pneumonia in hospitalized patients: a multicenter, prospective study in Japan. J Am Geriatr Soc. 2008;56:577–9.CrossRef
3.
go back to reference Taylor JK, Fleming GB, Singanayagam A, Hill AT, Chalmers JD. Risk factors for aspiration in community-acquired pneumonia: analysis of a hospitalized UK cohort. Am J Med. 2013;126:995–1001.CrossRef Taylor JK, Fleming GB, Singanayagam A, Hill AT, Chalmers JD. Risk factors for aspiration in community-acquired pneumonia: analysis of a hospitalized UK cohort. Am J Med. 2013;126:995–1001.CrossRef
4.
go back to reference Takemura K, Yoshimuta Y, Ono T, Kokubo Y, Kida M, Kosaka T, Yasui S, Nokubi T, Maeda Y. The relationship between masticatory ability and food feeding behaviors: the Suita Study. J Jpn Soc Mastication Sci Health Promot. 2013;23:81–9. Takemura K, Yoshimuta Y, Ono T, Kokubo Y, Kida M, Kosaka T, Yasui S, Nokubi T, Maeda Y. The relationship between masticatory ability and food feeding behaviors: the Suita Study. J Jpn Soc Mastication Sci Health Promot. 2013;23:81–9.
5.
go back to reference Yamamoto H, Furuya J, Tamada Y, Kondo H. Impacts of wearing complete dentures on bolus transport during feeding in elderly edentulous. J Oral Rehabil. 2013;40:923–31.CrossRef Yamamoto H, Furuya J, Tamada Y, Kondo H. Impacts of wearing complete dentures on bolus transport during feeding in elderly edentulous. J Oral Rehabil. 2013;40:923–31.CrossRef
6.
go back to reference Yoshida M, Masuda S, Amano J, Akagawa Y. Immediate effect of denture wearing on swallowing in rehabilitation hospital inpatients. J Am Geriatr Soc. 2013;61:655–7.CrossRef Yoshida M, Masuda S, Amano J, Akagawa Y. Immediate effect of denture wearing on swallowing in rehabilitation hospital inpatients. J Am Geriatr Soc. 2013;61:655–7.CrossRef
7.
go back to reference Ramos A, Asensio A, Caballos D, Mariño MJ. Prognostic factors associated with community-acquired aspiration pneumonia. Med Clin. 2002;119:81–4.CrossRef Ramos A, Asensio A, Caballos D, Mariño MJ. Prognostic factors associated with community-acquired aspiration pneumonia. Med Clin. 2002;119:81–4.CrossRef
8.
go back to reference Kim H, Jo S, Lee JB, Jin Y, Jeong T, Yoon J, Lee JM, Park B. Diagnostic performance of initial serum albumin level for predicting in-hospital mortality among aspiration pneumonia patients. Am J Emerg Med. 2018;36:5–11.CrossRef Kim H, Jo S, Lee JB, Jin Y, Jeong T, Yoon J, Lee JM, Park B. Diagnostic performance of initial serum albumin level for predicting in-hospital mortality among aspiration pneumonia patients. Am J Emerg Med. 2018;36:5–11.CrossRef
9.
go back to reference Ryu S, Oh SK, Cho SU, You Y, Park JS, Min JH, Jeong W, Cho YC, Ahn HJ, Kang C. Utility of the blood urea nitrogen to serum albumin ratio as a prognostic factor of mortality in aspiration pneumonia patients. Am J Emerg Med 2020. Ryu S, Oh SK, Cho SU, You Y, Park JS, Min JH, Jeong W, Cho YC, Ahn HJ, Kang C. Utility of the blood urea nitrogen to serum albumin ratio as a prognostic factor of mortality in aspiration pneumonia patients. Am J Emerg Med 2020.
10.
go back to reference Nakashima T, Maeda K, Tahira K, Taniguchi K, Mori K, Kiyomiya H, Akagi J. Silent aspiration predicts mortality in older adults with aspiration pneumonia admitted to acute hospitals. Geriatr Gerontol Int. 2018;18:828–32.CrossRef Nakashima T, Maeda K, Tahira K, Taniguchi K, Mori K, Kiyomiya H, Akagi J. Silent aspiration predicts mortality in older adults with aspiration pneumonia admitted to acute hospitals. Geriatr Gerontol Int. 2018;18:828–32.CrossRef
11.
go back to reference Naruishi K, Nishikawa Y. Swallowing impairment is a significant factor for predicting life prognosis of elderly at the end of life. Aging Clin Exp Res. 2018;30:77–80.CrossRef Naruishi K, Nishikawa Y. Swallowing impairment is a significant factor for predicting life prognosis of elderly at the end of life. Aging Clin Exp Res. 2018;30:77–80.CrossRef
12.
go back to reference Suzuki R, Kikutani T, Yoshida M, Yamashita Y, Hirayama Y. Prognosis-related factors concerning oral and general conditions for homebound older adults in Japan. Geriatr Gerontol Int. 2015;15:1001–6.CrossRef Suzuki R, Kikutani T, Yoshida M, Yamashita Y, Hirayama Y. Prognosis-related factors concerning oral and general conditions for homebound older adults in Japan. Geriatr Gerontol Int. 2015;15:1001–6.CrossRef
13.
go back to reference Papadopoulos D, Bader I, Gkioxari E, Petta V, Tsaras T, Galanopoulou N, Archontouli MA, Diamantea F, Kastanakis E, Karagianidis N, Filaditaki V. Microbiology and prognosis assessment of hospitalized patients with aspiration pneumonia: a single-center prospective cohort study. Infez Med. 2018;26:103–14.PubMed Papadopoulos D, Bader I, Gkioxari E, Petta V, Tsaras T, Galanopoulou N, Archontouli MA, Diamantea F, Kastanakis E, Karagianidis N, Filaditaki V. Microbiology and prognosis assessment of hospitalized patients with aspiration pneumonia: a single-center prospective cohort study. Infez Med. 2018;26:103–14.PubMed
14.
go back to reference Kohno S, Imamura Y, Shindo Y, Seki M, Ishida T, Teramoto S, Kadota J, Tomono K, Watanabe A. Clinical practice guidelines for nursing- and healthcare-associated pneumonia (NHCAP) [complete translation]. Respir Investig. 2013;51:103–26.CrossRef Kohno S, Imamura Y, Shindo Y, Seki M, Ishida T, Teramoto S, Kadota J, Tomono K, Watanabe A. Clinical practice guidelines for nursing- and healthcare-associated pneumonia (NHCAP) [complete translation]. Respir Investig. 2013;51:103–26.CrossRef
15.
go back to reference Eichner K. Renewed examination of the group classification of partially edentulous arches by Eichner and application advices for studies on morbidity statistics. Stomatologie der DDR. 1990;40:321–5.PubMed Eichner K. Renewed examination of the group classification of partially edentulous arches by Eichner and application advices for studies on morbidity statistics. Stomatologie der DDR. 1990;40:321–5.PubMed
16.
go back to reference Belafsky PC, Mouadeb DA, Rees CJ, Pryor JC, Postma GN, Allen J, Leonard RJ. Validity and reliability of the eating assessment tool (EAT-10). Ann Otol Rhinol Laryngol. 2008;117:919–24.CrossRef Belafsky PC, Mouadeb DA, Rees CJ, Pryor JC, Postma GN, Allen J, Leonard RJ. Validity and reliability of the eating assessment tool (EAT-10). Ann Otol Rhinol Laryngol. 2008;117:919–24.CrossRef
17.
go back to reference Oguchi K, Saitoh E, Mizuno M, Baba M, Okui M, Suzuki M. The repetitive saliva swallowing test (RSST) as a screening test of functional dysphagia (1) normal values of RSST. Jpn J Rehabil Med. 2000;37:375–82.CrossRef Oguchi K, Saitoh E, Mizuno M, Baba M, Okui M, Suzuki M. The repetitive saliva swallowing test (RSST) as a screening test of functional dysphagia (1) normal values of RSST. Jpn J Rehabil Med. 2000;37:375–82.CrossRef
18.
go back to reference Oguchi K, Saitoh E, Baba M, Kusudo S, Tanaka T, Onogi K. The repetitive saliva swallowing test (RSST) as a screening test of functional dysphagia (2) validity of RSST. Jpn J Rehabil Med. 2000;37:383–8.CrossRef Oguchi K, Saitoh E, Baba M, Kusudo S, Tanaka T, Onogi K. The repetitive saliva swallowing test (RSST) as a screening test of functional dysphagia (2) validity of RSST. Jpn J Rehabil Med. 2000;37:383–8.CrossRef
19.
go back to reference Wakabayashi H, Kayashita J. Translation, reliability, and validity of the Japanese version of the 10-item Eating Assessment Tool (EAT-10) for the screening of dysphagia. J Jpn Soc Parenter Enter Nutr. 2014;29:871–6. Wakabayashi H, Kayashita J. Translation, reliability, and validity of the Japanese version of the 10-item Eating Assessment Tool (EAT-10) for the screening of dysphagia. J Jpn Soc Parenter Enter Nutr. 2014;29:871–6.
20.
go back to reference Hyodo M, Nishikubo K, Hirose K. New scoring proposed for endoscopic swallowing evaluation and clinical significance. Nihon Jibiinkoka Gakkai kaiho. 2010;113:670–8.CrossRef Hyodo M, Nishikubo K, Hirose K. New scoring proposed for endoscopic swallowing evaluation and clinical significance. Nihon Jibiinkoka Gakkai kaiho. 2010;113:670–8.CrossRef
21.
go back to reference 2013 TddcotJSoDR: The Japanese Dysphagia Diet 2013. Jpn J Dysphagia Rehabil 17: 255–267, 2013. 2013 TddcotJSoDR: The Japanese Dysphagia Diet 2013. Jpn J Dysphagia Rehabil 17: 255–267, 2013.
22.
go back to reference Takata N, Yamagata Y, Kayashita J. A comparison of viscosity classifications between the Japanese Dysphagia diet 2013 criteria and the international dysphagia diet standardisation initiative. 2017. Takata N, Yamagata Y, Kayashita J. A comparison of viscosity classifications between the Japanese Dysphagia diet 2013 criteria and the international dysphagia diet standardisation initiative. 2017.
23.
go back to reference Langmore S, Pelletier C, Nelson R. Results of FEES survey on safety of endoscopy for swallowing assessment. Presented at Fourth Annual Meeting of the Dysphagia Research Society, McLean, VA, October 28, 1995. Langmore S, Pelletier C, Nelson R. Results of FEES survey on safety of endoscopy for swallowing assessment. Presented at Fourth Annual Meeting of the Dysphagia Research Society, McLean, VA, October 28, 1995.
24.
go back to reference Crary MA, Mann GDC, Groher ME. Initial psychometric assessment of a functional oral intake scale for dysphagia in stroke patients. Arch Phys Med Rehabil. 2005;86:1516–20.CrossRef Crary MA, Mann GDC, Groher ME. Initial psychometric assessment of a functional oral intake scale for dysphagia in stroke patients. Arch Phys Med Rehabil. 2005;86:1516–20.CrossRef
25.
go back to reference Steele CM, Namasivayam-MacDonald AM, Guida BT, Cichero JA, Duivestein J, Hanson B, Lam P, Riquelme LF. Creation and initial validation of the international dysphagia diet standardisation initiative functional diet scale. Arch Phys Med Rehabil. 2018;99:934–44.CrossRef Steele CM, Namasivayam-MacDonald AM, Guida BT, Cichero JA, Duivestein J, Hanson B, Lam P, Riquelme LF. Creation and initial validation of the international dysphagia diet standardisation initiative functional diet scale. Arch Phys Med Rehabil. 2018;99:934–44.CrossRef
26.
go back to reference Ohta T, Waga S, Handa W, Saito I, Takeuchi K. New grading of level of disordered consiousness (author’s transl). No shinkei geka Neurol Surg. 1974;2:623–7.PubMed Ohta T, Waga S, Handa W, Saito I, Takeuchi K. New grading of level of disordered consiousness (author’s transl). No shinkei geka Neurol Surg. 1974;2:623–7.PubMed
27.
go back to reference Mortensen EM, Coley CM, Singer DE, Marrie TJ, Obrosky DS, Kapoor WN, Fine MJ. Causes of death for patients with community-acquired pneumonia: Results from the pneumonia patient outcomes research team cohort study. Arch Int Med. 2002;162:1059–64.CrossRef Mortensen EM, Coley CM, Singer DE, Marrie TJ, Obrosky DS, Kapoor WN, Fine MJ. Causes of death for patients with community-acquired pneumonia: Results from the pneumonia patient outcomes research team cohort study. Arch Int Med. 2002;162:1059–64.CrossRef
28.
go back to reference Maeda K, Akagi J. Muscle Mass Loss Is a Potential Predictor of 90-Day Mortality in Older Adults with Aspiration Pneumonia. J Am Geriatr Soc. 2017;65:e18–22.CrossRef Maeda K, Akagi J. Muscle Mass Loss Is a Potential Predictor of 90-Day Mortality in Older Adults with Aspiration Pneumonia. J Am Geriatr Soc. 2017;65:e18–22.CrossRef
29.
go back to reference Avivi-Arber L, Sessle BJ. Jaw sensorimotor control in healthy adults and effects of ageing. J Oral Rehabil. 2018;45:50–80.CrossRef Avivi-Arber L, Sessle BJ. Jaw sensorimotor control in healthy adults and effects of ageing. J Oral Rehabil. 2018;45:50–80.CrossRef
30.
go back to reference Cera ML, Ortiz KZ, Bertolucci PH, Minett TS. Speech and orofacial apraxias in Alzheimer’s disease. Int Psychogeriatr. 2013;25:1679–85.CrossRef Cera ML, Ortiz KZ, Bertolucci PH, Minett TS. Speech and orofacial apraxias in Alzheimer’s disease. Int Psychogeriatr. 2013;25:1679–85.CrossRef
31.
go back to reference Taji T, Yoshida M, Hiasa K, Abe Y, Tsuga K, Akagawa Y. Influence of mental status on removable prosthesis compliance in institutionalized elderly persons. Int J Prosthodont. 2005;18:146–9.PubMed Taji T, Yoshida M, Hiasa K, Abe Y, Tsuga K, Akagawa Y. Influence of mental status on removable prosthesis compliance in institutionalized elderly persons. Int J Prosthodont. 2005;18:146–9.PubMed
32.
go back to reference Chiba Y, Sano D, Ikui Y, Nishimura G, Yabuki K, Arai Y, Tanabe T, Ikemiyagi H, Hyakusoku H, Oridate N. Predictive value of the Hyodo score in endoscopic evaluation of aspiration during swallowing. Auris Nasus Larynx. 2018;45:1214–20.CrossRef Chiba Y, Sano D, Ikui Y, Nishimura G, Yabuki K, Arai Y, Tanabe T, Ikemiyagi H, Hyakusoku H, Oridate N. Predictive value of the Hyodo score in endoscopic evaluation of aspiration during swallowing. Auris Nasus Larynx. 2018;45:1214–20.CrossRef
33.
go back to reference Clavé P, de Kraa M, Arreola V, Girvent M, Farré R, Palomera E, Serra-Prat M. The effect of bolus viscosity on swallowing function in neurogenic dysphagia. Aliment Pharmacol Ther. 2006;24:1385–94.CrossRef Clavé P, de Kraa M, Arreola V, Girvent M, Farré R, Palomera E, Serra-Prat M. The effect of bolus viscosity on swallowing function in neurogenic dysphagia. Aliment Pharmacol Ther. 2006;24:1385–94.CrossRef
34.
go back to reference Onodera S, Furuya J, Yamamoto H, Tamada Y, Kondo H. Effects of wearing and removing dentures on oropharyngeal motility during swallowing. J Oral Rehabil. 2016;43:847–54.CrossRef Onodera S, Furuya J, Yamamoto H, Tamada Y, Kondo H. Effects of wearing and removing dentures on oropharyngeal motility during swallowing. J Oral Rehabil. 2016;43:847–54.CrossRef
35.
go back to reference Yoshikawa M, Yoshida M, Nagasaki T, Tanimoto K, Tsuga K, Akagawa Y. Influence of aging and denture use on liquid swallowing in healthy dentulous and edentulous older people. J Am Geriatr Soc. 2006;54:444–9.CrossRef Yoshikawa M, Yoshida M, Nagasaki T, Tanimoto K, Tsuga K, Akagawa Y. Influence of aging and denture use on liquid swallowing in healthy dentulous and edentulous older people. J Am Geriatr Soc. 2006;54:444–9.CrossRef
36.
go back to reference Rofes L, Arreola V, Mukherjee R, Clavé P. Sensitivity and specificity of the eating assessment tool and the volume-viscosity swallow test for clinical evaluation of oropharyngeal dysphagia. Neurogastroenterol Motil. 2014;26:1256–65.CrossRef Rofes L, Arreola V, Mukherjee R, Clavé P. Sensitivity and specificity of the eating assessment tool and the volume-viscosity swallow test for clinical evaluation of oropharyngeal dysphagia. Neurogastroenterol Motil. 2014;26:1256–65.CrossRef
37.
go back to reference Hu X, Yi ES, Ryu JH. Aspiration-related deaths in 57 consecutive patients: autopsy study. PLoS ONE. 2014;9:e103795.CrossRef Hu X, Yi ES, Ryu JH. Aspiration-related deaths in 57 consecutive patients: autopsy study. PLoS ONE. 2014;9:e103795.CrossRef
38.
go back to reference Nishino T, Honda Y, Kohchi T, Shirahata M, Yonezawa T. Effects of increasing depth of anaesthesia on phrenic nerve and hypoglossal nerve activity during the swallowing reflex in cats. Br J Anaesth. 1985;57:208–13.CrossRef Nishino T, Honda Y, Kohchi T, Shirahata M, Yonezawa T. Effects of increasing depth of anaesthesia on phrenic nerve and hypoglossal nerve activity during the swallowing reflex in cats. Br J Anaesth. 1985;57:208–13.CrossRef
39.
go back to reference Teramoto S, Matsuse T, Oka T, Ito H, Fukuchi Y, Ouchi Y. Investigation of effects of anesthesia and age on aspiration in mice through LacZ gene transfer by recombinant E1-deleted adenovirus vectors. Am J Respir Crit Care Med. 1998;158:1914–9.CrossRef Teramoto S, Matsuse T, Oka T, Ito H, Fukuchi Y, Ouchi Y. Investigation of effects of anesthesia and age on aspiration in mice through LacZ gene transfer by recombinant E1-deleted adenovirus vectors. Am J Respir Crit Care Med. 1998;158:1914–9.CrossRef
40.
go back to reference Sato M, Tohara H, Iida T, Wada S, Inoue M, Ueda K. Simplified cough test for screening silent aspiration. Arch Phys Med Rehabil. 2012;93:1982–6.CrossRef Sato M, Tohara H, Iida T, Wada S, Inoue M, Ueda K. Simplified cough test for screening silent aspiration. Arch Phys Med Rehabil. 2012;93:1982–6.CrossRef
Metadata
Title
Relationships Between Survival and Oral Status, Swallowing Function, and Oral Intake Level in Older Patients with Aspiration Pneumonia
Authors
Taku Suzuki
Takanori Tsujimura
Jin Magara
Naohito Hao
Naru Shiraishi
Kazuya Maekawa
Kazuo Matsushima
Makoto Inoue
Publication date
01-06-2022
Publisher
Springer US
Published in
Dysphagia / Issue 3/2022
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-021-10306-3

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