Risk Factors for Liquid Aspiration among Dysphagic Patients with Schizophrenia

Abstract

Objective:　The aim of this study was to investigate the risk factors for liquid aspiration among dysphagic patients with schizophrenia.

Patients and Methods:　This study was performed retrospectively and included 225 dysphagic patients with schizophrenia that were referred to the Department of Dentistry and Oral Surgery of our hospital from November, 2009 to January, 2014. In this study, there were 122 males and 103 females, and the mean age was 65.5 years (standard deviation 12.5 years). Liquid aspiration was assessed by means of videoendoscopic examination of swallowing (VE). Doses of neuroleptics at the time of VE were converted to milligram equivalents of chlorpromazine (CP equivalent dose), and the mean CP equivalent dose at the time of VE was 501 mg/day (standard deviation 584 mg). We investigated the relationship of liquid aspiration to age, sex, activity of daily living, body mass index (BMI), CP equivalent dose, orofacial dyskinesia and gag reflex by univariate analysis and multivariate analysis by using logistic regression analysis (backward selection method).

Results:　The univariate analysis indicated that liquid aspiration was significantly related with the independency of daily living (p＝0.036), BMI (p＝0.022) and gag reflex (p＝0.004) whereas there were no significant relationship of the aspiration to sex, age, the independency of indoor living, sitting ability and orofacial dyskinesia. Logistic regression analysis indicated that there was significant relationship (p＝0.015) between gag reflex and the liquid aspiration whereas the relationships between the aspiration and the other 8 factors were not statistically significant.

Conclusion:　Logistic regression analysis indicated that the impairment of gag reflex was significantly related with the occurrence of the liquid aspiration among dysphagic patients with schizophrenia.