Abstract
Purpose: Our hospital has been working on early oral intake with team medical care since April 2015, to investigate the effect of early oral intake with team medical care on length of hospital stay and oral intake at discharge in inpatients with aspiration pneumonia.
Methods: A retrospective cohort study was performed in 380 patients aged 65 and over who were admitted to our hospital with aspiration pneumonia from April 2014 to March 2018. Patients who died were excluded. Diagnosis Procedure Combination (DPC) data including age, gender, required care level, living place before hospitalization, A-DROP (Age, Dehydration, Respiratory failure, Orientation disturbance and blood Pressure) at hospitalization, number of days from hospitalization to oral intake, presence of rehabilitation, fever after starting oral intake, length of hospital stay, the Functional Oral Intake Scale (FOIS) at discharge, presence of oral intake at discharge, and discharge destination were investigated retrospectively. We classified the subjects into the group without team medical care (2014) and the group with team medical care (2015-2017), and examined changes in both groups. We examined the effects of team medical care and early oral intake on length of hospital stay and oral intake at discharge statistically. A p-value ＜0.05 was determined to be statistically significant.
Results: Mean age was 85.9±7.0 years, and there were 208 men (55%). In univariate analysis, significant differences were observed in A-DROP at hospitalization, presence of rehabilitation, FOIS at discharge, oral intake at discharge, and length of hospital stay, between the group without team medical care and the group with team medical care. In multivariate analysis, factors affecting length of hospital stay were required care level (β ＝－0.215), living place before hospitalization (β ＝ 0.146), presence of team medical care (β ＝－0.151), start of oral intake within 2 days after hospitalization (β ＝－0.134), presence of rehabilitation (β ＝ 0.145), fever after starting oral intake (β ＝ 0.202), FOIS at discharge (β ＝－0.280), and discharge destination (β ＝－0.184). Factors affecting oral intake at discharge were age (odds ratio, OR ＝ 1.039), presence of team medical care (OR ＝ 3.196), and start of oral intake within 2 days after admission (OR ＝ 4.095).
Conclusion: Starting early oral intake while in acute care may improve not only patients’quality of life but also reduce length of hospital stay.
