Ryo Momosaki1,2, Hideo Yasunaga2, Hiroki Matsui2, Hiromasa Horiguchi3, Kiyohide Fushimi4, Masahiro Abo1. 1. Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan. 2. Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan. 3. Department of Clinical Data Management and Research, Clinical Research Center, National Hospital Organization Headquarters, Tokyo, Japan. 4. Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan.
Abstract
AIM: To clarify the effects of dysphagia rehabilitation on oral intake after aspiration pneumonia in older adults. METHODS: The present retrospective observational study used data from the Japanese Diagnosis Procedure Combination inpatient database. We identified patients who were admitted to acute care hospitals with aspiration pneumonia. Patients were subdivided into those with and without dysphagia rehabilitation. The main outcome variable was total oral intake on discharge. We carried out multivariate logistic regression analysis to assess the effect of dysphagia rehabilitation on the outcome, with adjustment for patient backgrounds. We also carried out analyses based on pneumonia severity, and the timing and duration of dysphagia rehabilitation. RESULTS: We identified 22,819 patients with dysphagia rehabilitation and 75,555 patients without dysphagia rehabilitation. The rates of total oral intake on discharge were 78.0 and 75.2%, respectively. The multivariate regression model showed that the dysphagia rehabilitation group had a significantly higher proportion of total oral intake on discharge (odds ratio 1.32; P < 0.001). Mild pneumonia patients had a higher odds ratio for total oral intake associated with dysphagia rehabilitation than patients with moderate and severe pneumonia (odds ratio 2.27; P < 0.001). Among patients who underwent a short period of dysphagia rehabilitation, those with early rehabilitation were more likely to achieve total oral intake at discharge than those with late rehabilitation. CONCLUSION: The data suggest that dysphagia rehabilitation had a positive effect on total oral intake in elderly patients with aspiration pneumonia. Dysphagia rehabilitation showed greater benefit in patients with mild pneumonia than with more severe pneumonia.
AIM: To clarify the effects of dysphagia rehabilitation on oral intake after aspiration pneumonia in older adults. METHODS: The present retrospective observational study used data from the Japanese Diagnosis Procedure Combination inpatient database. We identified patients who were admitted to acute care hospitals with aspiration pneumonia. Patients were subdivided into those with and without dysphagia rehabilitation. The main outcome variable was total oral intake on discharge. We carried out multivariate logistic regression analysis to assess the effect of dysphagia rehabilitation on the outcome, with adjustment for patient backgrounds. We also carried out analyses based on pneumonia severity, and the timing and duration of dysphagia rehabilitation. RESULTS: We identified 22,819 patients with dysphagia rehabilitation and 75,555 patients without dysphagia rehabilitation. The rates of total oral intake on discharge were 78.0 and 75.2%, respectively. The multivariate regression model showed that the dysphagia rehabilitation group had a significantly higher proportion of total oral intake on discharge (odds ratio 1.32; P < 0.001). Mild pneumoniapatients had a higher odds ratio for total oral intake associated with dysphagia rehabilitation than patients with moderate and severe pneumonia (odds ratio 2.27; P < 0.001). Among patients who underwent a short period of dysphagia rehabilitation, those with early rehabilitation were more likely to achieve total oral intake at discharge than those with late rehabilitation. CONCLUSION: The data suggest that dysphagia rehabilitation had a positive effect on total oral intake in elderly patients with aspiration pneumonia. Dysphagia rehabilitation showed greater benefit in patients with mild pneumonia than with more severe pneumonia.
Authors: David G Smithard; Ian Swaine; Salma Ayis; Alberto Gambaruto; Aoife Stone-Ghariani; Dharinee Hansjee; Stefan T Kulnik; Peter Kyberd; Elizabeth Lloyd-Dehler; William Oliff Journal: Pilot Feasibility Stud Date: 2022-05-19
Authors: Lee Hooper; Asmaa Abdelhamid; Sarah M Ajabnoor; Chizoba Esio-Bassey; Julii Brainard; Tracey J Brown; Diane Bunn; Eve Foster; Charlotte C Hammer; Sarah Hanson; Florence O Jimoh; Hassan Maimouni; Manraj Sandhu; Xia Wang; Lauren Winstanley; Jane L Cross; Ailsa A Welch; Karen Rees; Carl Philpott Journal: Clin Nutr ESPEN Date: 2021-11-19