ObjectiveTo investigate the association between the simple swallowing provocation test (SSPT) and development of aspiration pneumonia in patients with dysphagia in long-term care (LTC) wards.DesignThe study design was a prospective cohort study. Subjects were followed for 60 days from admission.SettingLTC wards.ParticipantsStudy subjects were patients with dysphagia aged 65 years or older who were admitted to LTC wards between August 2018 and August 2019. In total, 39 subjects were included in the analysis (20 males, 19 females; mean age 83.8 ± 8.5 years). Subjects were divided into two groups based on SSPT results: normal swallowing reflex (SSPT normal group) and abnormal swallowing reflex (SSPT abnormal group). The covariates were age and sex, primary disease, history of cerebrovascular disease, Glasgow coma scale, body mass index, geriatric nutritional risk index, the mann assessment of swallowing ability, food intake level scale, functional independence measure, and oral health assessment tool.InterventionsNot applicable.Main Outcome MeasureThe outcome was the incidence of aspiration pneumonia during the first 60 days of hospitalization, and the predictive factor was SSPT: 0.4 ml.ResultsThe incidence of aspiration pneumonia was 33.3% in the SSPT normal group and 76.2% in the SSPT abnormal group. The phi coefficient was −0.43, the risk ratio was 2.29, and the 95% confidence interval (95%CI) was 1.14 to 4.58. The predictive factor for aspiration pneumonia was SSPT: 0.4 ml (95% CI: 1.57–26.03).ConclusionsOur findings suggest that the SSPT provides a valid index for the development of aspiration pneumonia in older patients with dysphagia admitted to LTC wards.
This study aimed to determine predictive factors associated with poor outcomes among older adult inpatients in the convalescent rehabilitation ward. We also examined the validity of factors that were identified as predictive of poor outcomes. Study subjects were 104 older adult inpatients in the convalescent rehabilitation ward, divided into two groups based on outcome at discharge. Group I included the outcomes of death or transfer to an acute care hospital and Group II included all other outcomes. Data were retrospectively collected from older adults' medical records, including: activities of daily living, swallowing grade, nutritional index, and blood biochemistry data. Logistic regression analysis was used to extract predictive factors associated with poor outcomes. Next, we calculated the Stratum-specific likelihood ratio (SSLR) for each extracted factor. Two items were extracted as predictive factors with AUCs ≥ 0.7 : N-terminal pro-brain natriuretic peptide (NT-proBNP) and days from onset to hospitalization. The SSLRs showed the risk for a poor outcome increased when NT-proBNP was ≥ 2500 pg / ml, and when there were ≥ 35 days from onset to hospitalization. Our findings suggest these predictive factors provide a valid index to predict poor outcomes among older adults from the early stage of admission.
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