Association Between the Swallowing Reflex and the Development of Aspiration Pneumonia in Patients with Dysphagia Admitted to Long-term Care Wards -A Prospective Cohort Study of 60 Days- release_abdpyc4llbcollmieezi7tyvgy

Abstract

Objective: To investigate the association between the simple swallowing provocation test (SSPT) and development of aspiration pneumonia in patients with dysphagia in long-term care (LTC) wards. Design: The study design was a prospective cohort study. Subjects were followed for 60 days from admission. Setting: LTC wards. Participants: Study subjects were patients with dysphagia aged 65 years or older who were admitted to LTC wards between August 2018 and August 2019. In total, 39 subjects were included in the analysis (20 males, 19 females; mean age 83.8 ± 8.5 years). Subjects were divided into two groups based on SSPT results: normal swallowing reflex (SSPT normal group) and abnormal swallowing reflex (SSPT abnormal group). The covariates were age and sex, primary disease, history of cerebrovascular disease, Glasgow coma scale, body mass index, geriatric nutritional risk index, the mann assessment of swallowing ability, food intake level scale, functional independence measure, and oral health assessment tool. Interventions: Not applicable. Main Outcome Measure: The outcome was the incidence of aspiration pneumonia during the first 60 days of hospitalization, and the predictive factor was SSPT: 0.4 ml. Results: The incidence of aspiration pneumonia was 33.3% in the SSPT normal group and 76.2% in the SSPT abnormal group. The phi coefficient was −0.43, the risk ratio was 2.29, and the 95% confidence interval (95%CI) was 1.14 to 4.58. The predictive factor for aspiration pneumonia was SSPT: 0.4 ml (95% CI: 1.57-26.03). Conclusions: Our findings suggest that the SSPT provides a valid index for the development of aspiration pneumonia in older patients with dysphagia admitted to LTC wards.
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