Association between dysphagia risk and unplanned hospitalization in older patients receiving home medical care

Abstract

Aim Home medical care for older adults with chronic conditions is becoming an increasing important issue in Japan. We need to support long‐term medical care at home and avoid unplanned hospitalizations, which can adversely affect activities of daily living and quality of life. In this study, we investigated whether swallowing function is a risk for unplanned hospitalization in older patients with functional decline who are receiving home medical care. Methods In the current study, we examined data obtained in the Observational study of Nagoya Elderly with HOme MEdical study (ONEHOME) that investigated the medical health of older adults receiving home medical care services in Nagoya City, Japan. The data analyzed were patients’ age, sex, number of medications, Dysphagia Severity Scale, Charlson Comorbidity Index, Barthel Index, Mini Nutritional Assessment – Short Form, Frailty Index and dementia independent scale. The Dysphagia Severity Scale was categorized into the presence or absence of dysphagia risk. The association between dysphagia risk and days until first hospitalization was investigated by Cox regression analysis. Results In total, 86 out of 178 patients had a hospitalization during the study period of 4 years. Cox regression analysis with adjustment for age, sex, Charlson Comorbidity Index, Barthel Index and Mini Nutritional Assessment – Short Form scores showed that a lower Dysphagia Severity Scale score was significantly associated with unexpected hospitalization. Conclusions Dysphagia risk predicts the first unexpected hospitalization in older individuals receiving home medical care. Patients’ swallowing function is an important factor for estimating prognosis. Geriatr Gerontol Int 2019; 19: 977–981.

Effectiveness of fibreoptic endoscopic evaluation of swallowing and dietary intervention during home‐visit dental care in older individuals

“…Further, older people who need to manage chronic illnesses might find it difficult to visit outpatient clinics, especially with reduced independence in ADL. 25,26 Considering these circumstances, there is an increasing demand for geriatric medical services. However, it is still difficult for healthcare workers to provide appropriate medical care to the elders.…”

“…Older patients become fragile due to decreased functional reserve, which often occurs with senile syndrome associated with dementia, malnutrition, dysphagia, etc, resulting in decreased daily living activities (ADL). Further, older people who need to manage chronic illnesses might find it difficult to visit outpatient clinics, especially with reduced independence in ADL 25,26 …”

Yaşli Bi̇reylerde Pnömoni̇ Ve Yutma Fonksi̇yonlari Arasindaki̇ İli̇şki̇

“…The close relationship between malnutrition and swallowing disorder is due to the difficulty in swallowing and especially the aspiration of people with pneumonia, stalling of food, and coughing after eating, leading to decreased desire to eat (21). Malnutrition, as a result of swallowing disorder, also leads to severe consequences such as aspiration pneumonia (22). The struggle against malnutrition also creates a severe economic burden (23).…”

Preoperative dysphagia risk in community‐dwelling adults aged ≥50 years: Prevalence and risk factors

“…The prevalence of preoperative dysphagia risk was 9.3% and EAT-10 scores ranged from 0 to 32. Among patients with a positive EAT-10 score, the median was 6 (IQR, [4][5][6][7][8][9][10][11]. The characteristics of the patient cohort are displayed in Table 1, and patients with and without preoperative dysphagia risk are displayed in Table 2.…”