Original Paper
Risk Factors for Aspiration Pneumonia among Patients with Schizophrenia Suffering from Dysphagia
2013 Volume 17 Issue 1 Pages 52-59
Details
2013 Volume 17 Issue 1 Pages 52-59
Objective: The aim of this study was to investigate the risk factors for aspiration pneumonia among patients with schizophrenia suffering from dysphagia.
Patients: This study included 232 patients with schizophrenia who were referred to the Department of Dentistry and Oral Surgery of our hospital because of swallowing impairment, and the risk factors for aspiration pneumonia were retrospectively investigated. The numbers of males and females were 126 and 106, respectively, and the mean age of cases was 70.1 years (standard deviation: 11.8 years). Doses of neuroleptics were converted to milligram equivalents of chlorpromazine (CP equivalent dose), and the mean CP equivalent dose at the time of assessment of swallowing ability was 458 mg/day (standard deviation: 633 mg). The activity of daily living (ADL) was evaluated by the assessment of independence level in daily living established by the Ministry of Health, Labour and Welfare of Japan.
Results: Eighty (34.5%) cases developed aspiration pneumonia and the other 152 (65.5%) cases did not develop aspiration pneumonia within 3 months before the first visit to the Department of Dentistry and Oral Surgery. Functional Oral Intake Scale (FOIS) (p＝1.6×10－12), serum albumin (p＝9.0×10－6) and ADL (p＝5.7×10－7) were significantly lower in patients with aspiration pneumonia than in those without aspiration pneumonia. However, there were no significant differences in age (p＝0.111) and body mass index (BMI) (p＝0.509) between cases with and without the occurrence of aspiration pneumonia. In addition, there were no significant differences in the rates of males and females (p＝0.069) as well as in the rate of patients developing orofacial dyskinesia (p＝0.679) between cases with and without the occurrence of aspiration pneumonia. CP equivalent dose at the time of assessment of swallowing ability was significantly lower (p＝0.001) in patients with aspiration pneumonia than in those without aspiration pneumonia.
Conclusion: Impaired swallowing function as well as lowered ADL and ALB levels were strongly correlated to the occurrence of aspiration pneumonia.
