Vanessa R Y Hollaar1, Gert-Jan van der Putten2, Claar D van der Maarel-Wierink3, Ewald M Bronkhorst4, Bert J M de Swart5, Cees de Baat6, Nico H J Creugers7. 1. Department of Neurorehabilitation, HAN University of Applied Sciences, Nijmegen, The Netherlands; BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Ghent, Belgium; BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Nijmegen, The Netherlands; Department of Oral Function and Prosthetic Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. Electronic address: vanessa.hollaar@radboudumc.nl. 2. BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Ghent, Belgium; BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Nijmegen, The Netherlands; Department of Oral Function and Prosthetic Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands; Amaris Gooizicht, Hilversum, The Netherlands. 3. BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Ghent, Belgium; BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Nijmegen, The Netherlands; Center for Special Care in Dentistry, Amsterdam, The Netherlands. 4. Department of Preventive and Restorative Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. 5. Department of Neurorehabilitation, HAN University of Applied Sciences, Nijmegen, The Netherlands; Department of Rehabilitation, Division Speech Therapy, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. 6. BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Ghent, Belgium; BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Nijmegen, The Netherlands; Department of Oral Function and Prosthetic Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. 7. Department of Oral Function and Prosthetic Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
Abstract
BACKGROUND: Nursing home-acquired pneumonia (NHAP) is a common infection among nursing home residents. There is also a high prevalence of dysphagia in nursing home residents and they suffer more often from comorbidity and multimorbidity. This puts nursing home residents at higher risk of (mortality from) NHAP. Therefore it is important to gain more insight into the incidence of NHAP and the associated medical conditions in nursing home residents with dysphagia. OBJECTIVE: To investigate possible associations between NHAP and dysphagia in nursing home residents and to search for a medical risk profile for NHAP. DESIGN: A retrospective cross-sectional study. SETTING: Three nursing homes in The Netherlands. PARTICIPANTS: 416 electronic medical files of nursing home residents aged 65 or older living in 3 nursing homes. METHODS: Data about age, gender, diagnosis of dysphagia and/or pneumonia, medical diagnosis and possible cause of death of the nursing home residents were extracted from electronic medical files. RESULTS: The data of 373 electronic medical files were analyzed. A significant difference in the prevalence of dysphagia was found between the nursing homes (p < 0.001). The incidence of NHAP was 5-12% in the participating nursing homes. Statistically significant higher incidence of NHAP was found in residents with dysphagia (p = 0.046). Residents with dysphagia had statistically significantly more diseases compared to residents without dysphagia (p = 0.001). Logistic regression analyses revealed no statistically significant associations between NHAP and the number of diseases and the ICD-10 diseases. CONCLUSIONS: Dysphagia was found to be a risk factor for NHAP. Awareness of the signs of dysphagia by nurses and other care providers is important for early recognition and management of dysphagia and prevention of NHAP.
BACKGROUND: Nursing home-acquired pneumonia (NHAP) is a common infection among nursing home residents. There is also a high prevalence of dysphagia in nursing home residents and they suffer more often from comorbidity and multimorbidity. This puts nursing home residents at higher risk of (mortality from) NHAP. Therefore it is important to gain more insight into the incidence of NHAP and the associated medical conditions in nursing home residents with dysphagia. OBJECTIVE: To investigate possible associations between NHAP and dysphagia in nursing home residents and to search for a medical risk profile for NHAP. DESIGN: A retrospective cross-sectional study. SETTING: Three nursing homes in The Netherlands. PARTICIPANTS: 416 electronic medical files of nursing home residents aged 65 or older living in 3 nursing homes. METHODS: Data about age, gender, diagnosis of dysphagia and/or pneumonia, medical diagnosis and possible cause of death of the nursing home residents were extracted from electronic medical files. RESULTS: The data of 373 electronic medical files were analyzed. A significant difference in the prevalence of dysphagia was found between the nursing homes (p < 0.001). The incidence of NHAP was 5-12% in the participating nursing homes. Statistically significant higher incidence of NHAP was found in residents with dysphagia (p = 0.046). Residents with dysphagia had statistically significantly more diseases compared to residents without dysphagia (p = 0.001). Logistic regression analyses revealed no statistically significant associations between NHAP and the number of diseases and the ICD-10 diseases. CONCLUSIONS:Dysphagia was found to be a risk factor for NHAP. Awareness of the signs of dysphagia by nurses and other care providers is important for early recognition and management of dysphagia and prevention of NHAP.
Authors: Tjarda M Boere; Laura W van Buul; Rogier M Hopstaken; Ruth B Veenhuizen; Maurits W van Tulder; Jochen W L Cals; Theo J M Verheij; Cees M P M Hertogh Journal: BMC Health Serv Res Date: 2020-02-27 Impact factor: 2.655