[Objective] To explore factors related to repetitive aspiration pneumonia in elderly patients with dysphagia.
[Subjects] Sixty-eight patients admitted to the Tarumizu Municipal Medical Center Tarumizu Chuo Hospital, Japan between April 2007 and June 2009 with aspiration pneumonia were enrolled in the study. They were divided into two groups: those who were experiencing aspiration pneumonia once (primary group, n =53), and those experiencing a relapse of aspiration pneumonia (of two or more times) (relapse group, n =15).
[Method] Age, gender, length of hospital stay, number of stroke episodes, cognitive status, higher brain dysfunction, gait ability, food texture requirements, repetitive saliva swallow test (RSST), and modified water swallow test (MWST) were examined as independent variables.
[Results] The two groups were similar with respect to age, gender, length of hospital stay, and RSST. There were significant differences between the two groups in terms of number of stroke episodes, gait ability, and MWST. In the primary group, approximately 50% of patients were hospitalized from their home, while in the relapse group, approximately 87% were hospitalized from other facilities. In the relapse group, 64% had higher brain dysfunction; intention dysfunction and pacing dysfunction were particularly influenced by aspiration pneumonia.
[Conclusion] These factors may play an important role in predicting the recurrence of aspiration pneumonia. These results also show the importance of initial assessment ratings, and suggest a need for inter-rater reliability of assessment measures within rehabilitation facilities. We propose that knowledge about dysphagia should be given to the patients’ families upon leaving hospital, and that training methods for cognitive dysfunction, higher brain dysfunction and dysphagia should be closely examined.
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