2025 Volume 29 Issue 3 Pages 101-110
Objective: Aspiration pneumonia is a major cause of death in Japan, with malnutrition and swallowing dysfunction contributing to onset and severity. Oral intake of a regular diet plays an important role in nutritional management and preserving quality of life. This study investigated factors related to whether patients were able to consume a regular diet during hospitalization and at discharge who had been consuming a regular diet before admission for aspiration pneumonia.
Subjects: This study included 123 of 238 patients aged ≥ 65 years old hospitalized for aspiration pneumonia, who were consuming a regular diet (levels 8–10 on the Food Intake LEVEL Scale (FILS)) before admission. The patients were divided into a regular diet group and a dysphagia-modified diet group based on their FILS scores on day 7 after hospital admission. The discharge outcomes were compared. We analyzed the changes in diet between day 7 of hospital admission and at discharge, as well as factors related to consuming a regular diet, among the 101 patients discharged (61 men and 40 women).
Results: The survival-to-discharge rate was significantly higher in the regular diet group (63 patients, 91.3%) than in the dysphagia-modified diet group (38 patients, 70.4%) (p＜0.01). The survival-todischarge rate, FILS at discharge, and rate of return to their original residence were higher in the regular diet group than in the dysphagia-modified diet group. Those in the regular diet group had a higher body mass index (BMI) and Mini Nutritional Assessment-Short Form scores at admission as well as a higher Barthel index (BI) and energy intake on day 7 of hospitalization. A total of 57 of the 63 patients (90.5%) who consumed a regular diet on day 7 continued on a regular diet after discharge. The results of multivariate analysis for consuming a regular diet on day 7 showed that three factors―BI (odds ratio (OR) 1.04, p＝0.002), BMI (OR 1.22, p＝0.040), and energy intake (OR 1.08, p＝0.025)―were significantly associated with continuing on a regular diet after discharge. Similar associations were observed for those consuming a regular diet at discharge.
Conclusion: Aspiration pneumonia patients who were consuming a regular diet on day 7 of hospitalization were more likely to continue consuming a regular diet after discharge. Sufficient energy intake must be ensured from an early stage to enable patients to consume a regular diet at discharge, and comprehensive interventions including assessments of activities of daily living and swallowing function are necessary.
