2025 Volume 29 Issue 2 Pages 61-71
Objectives: Malnutrition and swallowing dysfunction are recognized risk factors for the onset and worsening of aspiration pneumonia. This study aimed to categorize patients with aspiration pneumonia into three groups based on their swallowing function, using the Food Intake Level Scale (FILS), and to investigate the relationship between energy intake and clinical outcomes. Additionally, the study investigated how nutritional factors, including those defined by the Global Leadership Initiative on Malnutrition (GLIM) criteria, impact survival until discharge.
Participants and Methods: Utilizing the FILS, we classified 115 patients (76 men and 39 women), aged 65 years, who were hospitalized for aspiration pneumonia into three groups: no oral intake, combined alternative feeding, and oral intake-only group. The relationship between energy intake, nutritional status based on GLIM, and survival to discharge was examined.
Results: According to the FILS, 32 patients (27.8%) had no oral intake, 23 (20%) had alternative feeding, and 60 (52.2%) had oral intake only. The energy intake per kg (kcal/kg) was 14 (6.9–21.3), 13.3 (8.6–19.3), and 20.6 (15.6–25.9) kcal/kg for the without oral intake-only group, respectively, suggesting that kcal/kg was significantly higher in the oral intake-only group than in the no oral intake group (p＜0.01).
As per the GLIM criteria, 60 (52%) patients were classified as severely malnourished; 34 (30%) as moderately malnourished; and 21 (18%) as not malnourished. In each group as classified according to the FILS, 24 patients (75%) were severely malnourished; 5 (16%) moderately malnourished; and 3 (9%) not malnourished. In the oral intake-only group, 25 (42%) patients were severely malnourished; 23 (38%) moderately malnourished; and 12 (20%) not malnourished, showing a significant association between the FILS and GLIM criteria, especially between the oral intake-only and no oral intake groups (p＜0.05).
Survival to discharge was significantly higher in the oral intake-only group (88.3%) than the no oral intake group (59.4%) (p＜0.01). Multivariate analysis revealed a significant relationship between energy intake per kg (kcal/kg) and survival to discharge (OR: 1.09, 95% CI: 1.01–1.17, p＜0.01).
Conclusion: In patients with aspiration pneumonia, there was a significant association between energy intake and survival until hospital discharge. The oral intake-only group had significantly higher energy intake compared to those relying on alternative nutrition. These findings underscore the importance of evaluating FILS levels and energy intake to improve clinical outcomes for patients with aspiration pneumonia.
