Predictors for achieving oral intake in older patients with aspiration pneumonia: Videofluoroscopic evaluation of swallowing function

Pneumonia is a common disease that is often fatal, particularly in older persons. Dysphagia is known to be closely associated with aspiration pneumonia, and hospitalized patients with aspiration pneumonia often have difficulty with oral intake. However, the relationship between acquisition of oral intake and detailed swallowing data has not been explored. The purpose of the present study was to examine the predictors, including videofluoroscopic swallowing evaluation, for achieving oral intake in older patients with aspiration pneumonia.

This study included older patients, aged ≥65 years, who were admitted to Kawasaki Municipal Hospital (Kawasaki, Japan) from April 2012 through March 2014 as a result of aspiration pneumonia. Factors likely related to oral intake, including swallowing, nutritional, metabolic, and functional status, pneumonia severity and comorbidities were extracted from the medical records. Multiple logistic regression analysis was carried out to identify independent predictors for acquisition of oral intake.

A total of 160 patients were assigned to either the "oral intake" group (n = 104) or the "non-oral intake" group (n = 56). Multiple regression analysis showed that a low penetration aspiration scale on videofluoroscopy using 3 mL of moderately thick liquid water with tilting 30-60°, high albumin values, short duration of non-oral intake and a high Food Intake Level Scale score before admission were significantly associated with achievement of oral intake.

Aspiration on videofluoroscopy, swallowing status before admission, nutritional status and duration of non-oral intake are important factors for acquiring oral intake. These results might be helpful for the management of older patients with aspiration pneumonia. Geriatr Gerontol Int 2018; 18: 1469-1473.