Toshiyuki Yamamoto1, Yoko Kobayashi, Miho Murata. 1. Department of Rehabilitation, National Center Hospital of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira City, Tokyo 187-8551, Japan.
Abstract
OBJECTIVE: We investigated the time course of pneumonia onset and duration of continued oral intake following videofluorography (VFG) in patients with Lewy body disease. PATIENTS AND METHODS: Subjects were 90 patients with idiopathic Parkinson's disease (IPD) and 45 with Lewy body dementia (LBD). We performed a follow-up study of the time from VFG until onset of pneumonia or discontinuation of oral intake, up to a maximum of 24 months, and determined the associated risk factors. We evaluated the cumulative rates of pneumonia onset and continued oral intake over 24 months for each disease. RESULTS: Among patients with Lewy body disease, 53 developed pneumonia and 21 discontinued oral intake; patients with aspiration fared significantly worse [hazard ratio (HR) = 26.62, 3.21, p < 0.01, = 0.05]. Hoehn-Yahr (HY) stage during VFG was also a risk factor for discontinuation of oral intake. The cumulative rate of pneumonia onset was significantly higher in the aspiration group for both IPD and LBD (p < 0.01, <0.01). The cumulative rate of continued oral intake tended to be lower in the aspiration group for IPD, and was significantly lower for LBD (p = 0.07, <0.01). CONCLUSION: Aspiration during VFG was a risk factor for pneumonia onset in patients with Lewy body disease. Aspiration and HY stage during VFG were risk factors for discontinuing oral intake. The cumulative rate of continued oral intake up to 24 months after VFG was poorest for LBD patients with aspiration.
OBJECTIVE: We investigated the time course of pneumonia onset and duration of continued oral intake following videofluorography (VFG) in patients with Lewy body disease. PATIENTS AND METHODS: Subjects were 90 patients with idiopathic Parkinson's disease (IPD) and 45 with Lewy body dementia (LBD). We performed a follow-up study of the time from VFG until onset of pneumonia or discontinuation of oral intake, up to a maximum of 24 months, and determined the associated risk factors. We evaluated the cumulative rates of pneumonia onset and continued oral intake over 24 months for each disease. RESULTS: Among patients with Lewy body disease, 53 developed pneumonia and 21 discontinued oral intake; patients with aspiration fared significantly worse [hazard ratio (HR) = 26.62, 3.21, p < 0.01, = 0.05]. Hoehn-Yahr (HY) stage during VFG was also a risk factor for discontinuation of oral intake. The cumulative rate of pneumonia onset was significantly higher in the aspiration group for both IPD and LBD (p < 0.01, <0.01). The cumulative rate of continued oral intake tended to be lower in the aspiration group for IPD, and was significantly lower for LBD (p = 0.07, <0.01). CONCLUSION: Aspiration during VFG was a risk factor for pneumonia onset in patients with Lewy body disease. Aspiration and HY stage during VFG were risk factors for discontinuing oral intake. The cumulative rate of continued oral intake up to 24 months after VFG was poorest for LBD patients with aspiration.
Authors: Elisabet Londos; Oskar Hanxsson; Ingrid Alm Hirsch; Anna Janneskog; Margareta Bülow; Sebastian Palmqvist Journal: BMC Neurol Date: 2013-10-07 Impact factor: 2.474