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Published in: Dysphagia 4/2020

01-08-2020 | Aspiration Pneumonia | Original Article

Impact of Multiple Texture-Modified Diets on Oral Intake and Nutritional Status in Older Patients with Pneumonia: A Retrospective Cohort Study

Authors: Akio Shimizu, Ryo Momosaki, Jun Kayashita, Ichiro Fujishima

Published in: Dysphagia | Issue 4/2020

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Abstract

Texture-modified diets (TMD) is often used in clinical practices for the treatment and prevention of pneumonia. However, it is unclear how stages of TMD affect the swallowing ability and nutritional status in patients with pneumonia. This study aimed to investigate the relationship between the various stages of TMD and swallowing ability and nutritional status in older inpatients with pneumonia. In this retrospective cohort study, data for patients aged ≥ 65 years with pneumonia were obtained from the Japan Rehabilitation Nutrition Database. We performed coarsened exact matching with Mini Nutritional Assessment Short Form (MNA-SF) on admission. Ultimately, 218 patients (mean age 82.9 ± 9.8 years) were included and divided into two groups based on the stages of TMD in the facility: multiple TMD (M-TMD) group (stages of TMD ≥ 6) and control group (stages of TMD < 6). The main outcome was the rate of improvement in the Food Intake Level Scale (FILS) and the maintenance or improvement in the MNA-SF score. We used the within-hospital correction with generalized estimation equations that are commonly used to analyze clustered data while correcting for confounding factors by clustering. Multivariate multiple logistic analysis showed that M-TMD was independently associated with FILS improvement rate and the maintenance or improvement in the MNA-SF score (odds ratio [OR] 3.252; 95% confidence interval [CI] 1.602–6.601; p = 0.001 and OR 1.873; 95% CI 1.054–3.330; p = 0.032, respectively). M-TMD in the facility was associated with the maintenance or improvement in swallowing ability and the nutritional status of patients with pneumonia.
Literature
1.
go back to reference Trotter CL, Stuart JM, George R, Miller E. Increasing hospital admissions for pneumonia, England. Emerg Infect Dis. 2008;14:727–33.CrossRef Trotter CL, Stuart JM, George R, Miller E. Increasing hospital admissions for pneumonia, England. Emerg Infect Dis. 2008;14:727–33.CrossRef
2.
go back to reference Quan TP, Fawcett NJ, Wrightson JM, Finney J, Wyllie D, Jeffery K, et al. Increasing burden of community-acquired pneumonia leading to hospitalisation, 1998–2014. Thorax. 2016;71:535–42.CrossRef Quan TP, Fawcett NJ, Wrightson JM, Finney J, Wyllie D, Jeffery K, et al. Increasing burden of community-acquired pneumonia leading to hospitalisation, 1998–2014. Thorax. 2016;71:535–42.CrossRef
3.
go back to reference Ramirez JA, Wiemken TL, Peyrani P, Arnold FW, Kelley R, Mattingly WA, et al. Adults hospitalized with Pneumonia in the United States: incidence, epidemiology, and mortality. Clin Infect Dis. 2017;65:1806–12.CrossRef Ramirez JA, Wiemken TL, Peyrani P, Arnold FW, Kelley R, Mattingly WA, et al. Adults hospitalized with Pneumonia in the United States: incidence, epidemiology, and mortality. Clin Infect Dis. 2017;65:1806–12.CrossRef
4.
go back to reference Miyashita N, Yamauchi Y. Bacterial Pneumonia in elderly Japanese populations. Japanese Clin Med. 2018;9:1179670717751433.CrossRef Miyashita N, Yamauchi Y. Bacterial Pneumonia in elderly Japanese populations. Japanese Clin Med. 2018;9:1179670717751433.CrossRef
5.
go back to reference Teramoto S, Fukuchi Y, Sasaki H, Sato K, Sekizawa K, Matsuse T, et al. 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, et al. 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
6.
go back to reference Clavé P, Shaker R. Dysphagia: current reality and scope of the problem. Nat Rev Gastroenterol Hepatol. 2015;12:259–70.CrossRef Clavé P, Shaker R. Dysphagia: current reality and scope of the problem. Nat Rev Gastroenterol Hepatol. 2015;12:259–70.CrossRef
7.
go back to reference Martín A, Ortega O, Roca M, Arús M, Clavé Civit P. Effect of a minimal-massive intervention in hospitalized older patients with oropharyngeal dysphagia: a proof of concept study. J Nutr Health Aging. 2018;22:739–47.CrossRef Martín A, Ortega O, Roca M, Arús M, Clavé Civit P. Effect of a minimal-massive intervention in hospitalized older patients with oropharyngeal dysphagia: a proof of concept study. J Nutr Health Aging. 2018;22:739–47.CrossRef
8.
go back to reference Wakabayashi H. Rehabilitation nutrition in general and family medicine. J Gen Fam Med. 2017;18:153–4.CrossRef Wakabayashi H. Rehabilitation nutrition in general and family medicine. J Gen Fam Med. 2017;18:153–4.CrossRef
9.
go back to reference Cichero JAY, Steele C, Duivestein J, Clavé P, Chen J, Kayashita J, et al. The need for international terminology and definitions for texture-modified foods and thickened liquids used in dysphagia management: foundations of a global initiative. Curr Phys Med Rehabil Rep. 2013;1:280–91.CrossRef Cichero JAY, Steele C, Duivestein J, Clavé P, Chen J, Kayashita J, et al. The need for international terminology and definitions for texture-modified foods and thickened liquids used in dysphagia management: foundations of a global initiative. Curr Phys Med Rehabil Rep. 2013;1:280–91.CrossRef
10.
go back to reference Newman R, Vilardell N, Clavé P, Speyer R. Effect of bolus viscosity on the safety and efficacy of swallowing and the kinematics of the swallow response in patients with oropharyngeal dysphagia: white paper by the european society for swallowing disorders (ESSD). Dysphagia. 2016;31:232–49.CrossRef Newman R, Vilardell N, Clavé P, Speyer R. Effect of bolus viscosity on the safety and efficacy of swallowing and the kinematics of the swallow response in patients with oropharyngeal dysphagia: white paper by the european society for swallowing disorders (ESSD). Dysphagia. 2016;31:232–49.CrossRef
11.
go back to reference Wright L, Cotter D, Hickson M. The effectiveness of targeted feeding assistance to improve the nutritional intake of elderly dysphagic patients in hospital. J Hum Nutr Diet. 2008;21:555–62.CrossRef Wright L, Cotter D, Hickson M. The effectiveness of targeted feeding assistance to improve the nutritional intake of elderly dysphagic patients in hospital. J Hum Nutr Diet. 2008;21:555–62.CrossRef
12.
go back to reference Keller H, Chambers L, Niezgoda H, Duizer L. Issues associated with the use of modified texture foods. J Nutr Health Aging. 2012;16:195–200.CrossRef Keller H, Chambers L, Niezgoda H, Duizer L. Issues associated with the use of modified texture foods. J Nutr Health Aging. 2012;16:195–200.CrossRef
13.
go back to reference Shimizu A, Maeda K, Tanaka K, Ogawa M, Kayashita J. Texture-modified diets are associated with decreased muscle mass in older adults admitted to a rehabilitation ward. Geriatr Gerontol Int. 2018;18:698–704.CrossRef Shimizu A, Maeda K, Tanaka K, Ogawa M, Kayashita J. Texture-modified diets are associated with decreased muscle mass in older adults admitted to a rehabilitation ward. Geriatr Gerontol Int. 2018;18:698–704.CrossRef
14.
go back to reference Kaneoka A, Pisegna JM, Saito H, Lo M, Felling K, Haga N, et al. A systematic review and meta-analysis of pneumonia associated with thin liquid vs. thickened liquid intake in patients who aspirate. Clin Rehabil. 2017;31:1116–25.CrossRef Kaneoka A, Pisegna JM, Saito H, Lo M, Felling K, Haga N, et al. A systematic review and meta-analysis of pneumonia associated with thin liquid vs. thickened liquid intake in patients who aspirate. Clin Rehabil. 2017;31:1116–25.CrossRef
15.
go back to reference Beck AM, Kjaersgaard A, Hansen T, Poulsen I. Systematic review and evidence based recommendations on texture modified foods and thickened liquids for adults (above 17 years) with oropharyngeal dysphagia—an updated clinical guideline. Clin Nutr. 2017;8:e127–e134134. Beck AM, Kjaersgaard A, Hansen T, Poulsen I. Systematic review and evidence based recommendations on texture modified foods and thickened liquids for adults (above 17 years) with oropharyngeal dysphagia—an updated clinical guideline. Clin Nutr. 2017;8:e127–e134134.
16.
go back to reference Cichero JAY, Lam P, Steele CM, Hanson B, Chen J, Dantas RO, et al. Development of international terminology and definitions for texture-modified foods and thickened fluids used in dysphagia management: the IDDSI framework. Dysphagia. 2017;32:293–314.CrossRef Cichero JAY, Lam P, Steele CM, Hanson B, Chen J, Dantas RO, et al. Development of international terminology and definitions for texture-modified foods and thickened fluids used in dysphagia management: the IDDSI framework. Dysphagia. 2017;32:293–314.CrossRef
17.
go back to reference Wakabayashi H, Sakuma K. Rehabilitation nutrition for sarcopenia with disability: a combination of both rehabilitation and nutrition care management. J Cachexia Sarcopenia Muscle. 2014;5:269–77.CrossRef Wakabayashi H, Sakuma K. Rehabilitation nutrition for sarcopenia with disability: a combination of both rehabilitation and nutrition care management. J Cachexia Sarcopenia Muscle. 2014;5:269–77.CrossRef
18.
go back to reference Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)-A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377–81.CrossRef Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)-A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377–81.CrossRef
19.
go back to reference Takasaki M, Momosaki R, Wakabayashi H, Nishioka S. Construction and quality evaluation of the japanese rehabilitation nutrition database. J Nutr Sci Vitaminol (Tokyo). 2018;64:251–7.CrossRef Takasaki M, Momosaki R, Wakabayashi H, Nishioka S. Construction and quality evaluation of the japanese rehabilitation nutrition database. J Nutr Sci Vitaminol (Tokyo). 2018;64:251–7.CrossRef
20.
go back to reference Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.CrossRef Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.CrossRef
21.
go back to reference Miyashita N, Matsushima T, Oka M. The JRS guidelines for the management of community-acquired Pneumonia in adults: an update and new recommendations. Intern Med. 2006;45:419–28.CrossRef Miyashita N, Matsushima T, Oka M. The JRS guidelines for the management of community-acquired Pneumonia in adults: an update and new recommendations. Intern Med. 2006;45:419–28.CrossRef
23.
go back to reference Kaiser MJ, Bauer JM, Ramsch C, Uter W, Guigoz Y, Cederholm T, et al. Validation of the Mini Nutritional Assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutr Health Aging. 2009;13:782–8.CrossRef Kaiser MJ, Bauer JM, Ramsch C, Uter W, Guigoz Y, Cederholm T, et al. Validation of the Mini Nutritional Assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutr Health Aging. 2009;13:782–8.CrossRef
25.
go back to reference Riquelme R, Torres A, El-ebiary M, Mensa J, Estruch R, Ruiz M, et al. Community-acquired Pneumonia in the elderly. Am J Respir Crit Care Med. 1997;156:1908–14.CrossRef Riquelme R, Torres A, El-ebiary M, Mensa J, Estruch R, Ruiz M, et al. Community-acquired Pneumonia in the elderly. Am J Respir Crit Care Med. 1997;156:1908–14.CrossRef
27.
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
28.
go back to reference Vucea V, Keller HH, Morrison JM, Duncan AM, Duizer LM, Lengyel CO, et al. Intake and factors associated with consumption of pureed food in long term care: an analysis of making the most of mealtimes (M3) project. J Nutr Gerontol Geriatr. 2018;37:59–81.CrossRef Vucea V, Keller HH, Morrison JM, Duncan AM, Duizer LM, Lengyel CO, et al. Intake and factors associated with consumption of pureed food in long term care: an analysis of making the most of mealtimes (M3) project. J Nutr Gerontol Geriatr. 2018;37:59–81.CrossRef
29.
go back to reference Atherton M, Bellis-Smith N, Cichero JAY, Suter M. Texture-modified foods and thickened fluids as used for individuals with dysphagia: Australian standardised labels and definitions. Nutr Diet. 2007;64:S53–76.CrossRef Atherton M, Bellis-Smith N, Cichero JAY, Suter M. Texture-modified foods and thickened fluids as used for individuals with dysphagia: Australian standardised labels and definitions. Nutr Diet. 2007;64:S53–76.CrossRef
30.
go back to reference Shibata S, Kagaya H, Tanaka S, Fujii W, Nakagawa K, Matsuo K, et al. Efficacy of a novel training food based on the process model of feeding for mastication and swallowing: a study among dysphagia patients. Jpn J Compr Rehabil Sci. 2017;8:82–7. Shibata S, Kagaya H, Tanaka S, Fujii W, Nakagawa K, Matsuo K, et al. Efficacy of a novel training food based on the process model of feeding for mastication and swallowing: a study among dysphagia patients. Jpn J Compr Rehabil Sci. 2017;8:82–7.
32.
go back to reference Wright L, Cotter D, Hickson M, Frost G. Comparison of energy and protein intakes of older people consuming a texture modified diet with a normal hospital diet. J Hum Nutr Diet. 2005;18:213–9.CrossRef Wright L, Cotter D, Hickson M, Frost G. Comparison of energy and protein intakes of older people consuming a texture modified diet with a normal hospital diet. J Hum Nutr Diet. 2005;18:213–9.CrossRef
33.
go back to reference Vucea V, Keller HH, Morrison JM, Duncan AM, Duizer LM, Carrier N, et al. Nutritional quality of regular and pureed menus in Canadian long term care homes: an analysis of the Making the Most of Mealtimes (M3) project. BMC Nutr. 2017;3:80.CrossRef Vucea V, Keller HH, Morrison JM, Duncan AM, Duizer LM, Carrier N, et al. Nutritional quality of regular and pureed menus in Canadian long term care homes: an analysis of the Making the Most of Mealtimes (M3) project. BMC Nutr. 2017;3:80.CrossRef
34.
go back to reference Reyes-Torres CA, Castillo-Martínez L, Reyes-Guerrero R, Ramos-Vázquez AG, Zavala-Solares M, Cassis-Nosthas L, et al. Design and implementation of modified-texture diet in older adults with oropharyngeal dysphagia: a randomized controlled trial. Eur J Clin Nutr. 2019;73:989–96.CrossRef Reyes-Torres CA, Castillo-Martínez L, Reyes-Guerrero R, Ramos-Vázquez AG, Zavala-Solares M, Cassis-Nosthas L, et al. Design and implementation of modified-texture diet in older adults with oropharyngeal dysphagia: a randomized controlled trial. Eur J Clin Nutr. 2019;73:989–96.CrossRef
Metadata
Title
Impact of Multiple Texture-Modified Diets on Oral Intake and Nutritional Status in Older Patients with Pneumonia: A Retrospective Cohort Study
Authors
Akio Shimizu
Ryo Momosaki
Jun Kayashita
Ichiro Fujishima
Publication date
01-08-2020
Publisher
Springer US
Published in
Dysphagia / Issue 4/2020
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-019-10063-4

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