Takeshi Nakashima1, Keisuke Maeda2,3, Kanae Tahira1, Kousuke Taniguchi1, Kumiko Mori1, Hiroyasu Kiyomiya1, Junji Akagi4. 1. Department of Dentistry and Oral Surgery, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan. 2. Palliative Care Center, Aichi Medical University, Nagakute, Japan. 3. Department of Nutrition and Dysphagia Rehabilitation, Tamana Regional Health Medical Center, Kumamoto, Japan. 4. Department of Surgery, Tamana Regional Health Medical Center, Kumamoto, Japan.
Abstract
AIM: Aspiration pneumonia is a common disease resulting in poor outcomes for older adults. It is known that silent aspiration might lead to aspiration pneumonia, but its role in this is unclear. The aim of the present study was to investigate whether silent aspiration is associated with mortality in aspiration pneumonia patients. METHODS: A multicenter (acute hospital) study including 170 aspiration pneumonia patients was carried out. Cough latency time after inhalation of 1% citric acid mist was used to assess silent aspiration. Patients were divided into two groups: silent aspirator (SA) and no-SA groups based on the latency time of ≥29/<29 s. RESULTS: The mean age of the participants was 84.0 ± 8.8 years. A total of 82% of them had moderate aspiration pneumonia. A total of 99 (58.2%) patients were in the SA group. Silent aspiration patients were more likely to be inactive compared with those in the no-SA group (Barthel Index score 5 [IQR 0-45] vs 30 [IQR 5-65], P = 0.023) and had worse oral conditions (Oral Health Assessment Tool score 5.3 ± 3.2 vs 3.8 ± 3.1, P = 0.003). Nine of the SA patients and one of the no-SA patients (P = 0.047) died within a month. Multivariate regression analysis showed that silent aspiration was associated with mortality after adjusting for confounders (odds ratio 2.65, 95% CI 1.01-6.98, P = 0.049). CONCLUSIONS: Silent aspiration detected by a cough latency test can predict 1-month mortality in older patients with aspiration pneumonia. More studies are required to investigate whether enhancing cough reflex treatments would help patients recover from aspiration pneumonia. Geriatr Gerontol Int 2018; 18: 828-832.
AIM: Aspiration pneumonia is a common disease resulting in poor outcomes for older adults. It is known that silent aspiration might lead to aspiration pneumonia, but its role in this is unclear. The aim of the present study was to investigate whether silent aspiration is associated with mortality in aspiration pneumoniapatients. METHODS: A multicenter (acute hospital) study including 170 aspiration pneumoniapatients was carried out. Cough latency time after inhalation of 1% citric acid mist was used to assess silent aspiration. Patients were divided into two groups: silent aspirator (SA) and no-SA groups based on the latency time of ≥29/<29 s. RESULTS: The mean age of the participants was 84.0 ± 8.8 years. A total of 82% of them had moderate aspiration pneumonia. A total of 99 (58.2%) patients were in the SA group. Silent aspiration patients were more likely to be inactive compared with those in the no-SA group (Barthel Index score 5 [IQR 0-45] vs 30 [IQR 5-65], P = 0.023) and had worse oral conditions (Oral Health Assessment Tool score 5.3 ± 3.2 vs 3.8 ± 3.1, P = 0.003). Nine of the SApatients and one of the no-SApatients (P = 0.047) died within a month. Multivariate regression analysis showed that silent aspiration was associated with mortality after adjusting for confounders (odds ratio 2.65, 95% CI 1.01-6.98, P = 0.049). CONCLUSIONS: Silent aspiration detected by a cough latency test can predict 1-month mortality in older patients with aspiration pneumonia. More studies are required to investigate whether enhancing cough reflex treatments would help patients recover from aspiration pneumonia. Geriatr Gerontol Int 2018; 18: 828-832.
Authors: Michael Janto; Raluca Iurcov; Cristian Marius Daina; Daniela Carmen Neculoiu; Alina Cristiana Venter; Dana Badau; Adrian Cotovanu; Marcel Negrau; Corina Lacramioara Suteu; Monica Sabau; Lucia Georgeta Daina Journal: J Pers Med Date: 2022-02-28