2020 Volume 24 Issue 2 Pages 113-120
Purpose: The purpose of this study was to examine the relationship between the ability of deglutition and the possibility of home discharge in elderly patients with cardiovascular disease who were admitted to an acute care hospital.
Methods: The design of this study was a retrospective cohort study. We analyzed the characteristic of each factor by calculating risk ratios which are thought to affect the possibility of home discharge: age (≥ 75 or ＜ 75 years old); presence or absence of history of hospitalization for deglutition pneumonia; presence or absence of cohabiting family; meal form before hospitalization; meal assistance or none before hospitalization; presence or absence of dementia; modified water swallowing test at speech therapist (ST) intervention (MWST: 0–3 or ≥ 4); repetitive saliva swallowing test at ST intervention (RSST: 0–2 or ≥ 3); eating and swallowing grade (Fujishima's grade) at ST intervention (Gr ＜ 7 or ≥ 7); food intake level scale at ST intervention (Lv ＜ 7 or ≥ 7).
Results: The risk ratio (95% CI) of factors that prevent discharge to the home for which significance was shown by the statistical test: There were three factors “Age ＞ 75 years” 8.5 (1.2–60.8), “Eating and swallowing grade ＜ 7” 3.0 (0.9–9.4) and “dementia” 2.8 (1.2–6.1).
Conclusion: Among the multiple deglutition function evaluations, only eating and swallowing grade was found to be an independent factor for the possibility of home discharge. The reason why eating and swallowing Gr became a factor in home discharge is because it is an index for comprehensively evaluating swallowing function and ability.
These results suggest that smooth discharge can be adjusted by using the eating and swallowing grade from an early stage of hospitalization.
