Effect of early rehabilitation on activities of daily living in patients with aspiration pneumonia

Yagi, Masayuki; Yasunaga, Hideo; Matsui, Hiroki; Fushimi, Kiyohide; Fujimoto, Masashi; Koyama, Takeo; Fujitani, Junko

doi:10.1111/ggi.12610

Cited by 23 publications

(27 citation statements)

References 29 publications

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“…Yagi et al. showed that 71% of elderly AP patients with hospitalization‐associated disability did not have improved ADL scores during hospitalization 7. However, the study showed that early rehabilitation improved ADL significantly (odds ratio, 1.6; 95% confidence interval [CI], 1.5‐1.6).…”

Section: Methods and Resultsmentioning

confidence: 95%

Rehabilitative management for aspiration pneumonia in elderly patients

Momosaki

2017

J of Gen and Family Med

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Aspiration pneumonia is a common disease that frequently occurs in elderly patients. Most patients with aspiration pneumonia have swallowing disability and develop hospital‐acquired disability. Frequently, patients have difficulty returning home, and they often require long‐term hospitalization. Recently, the effectiveness of rehabilitative management including physical, pulmonary, and dysphagia rehabilitation for aspiration pneumonia was reported. Several studies showed that early rehabilitation was associated with reduced mortality and early hospital discharge after aspiration pneumonia. Unnecessary “nil by mouth” directives associated with aspiration pneumonia at hospital admission resulted in adverse effects, including decline in swallowing ability and prolonged treatment duration. Rehabilitative management combined with appropriate nutrition is recommended to improve clinical outcomes, including physical and swallowing function in geriatric patients with aspiration pneumonia.

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Section: Methods and Resultsmentioning

confidence: 95%

Rehabilitative management for aspiration pneumonia in elderly patients

Momosaki

2017

J of Gen and Family Med

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“…Early rehabilitation showed an effect in preventing decreased functional status in elderly aspiration pneumonia patients, but it also increased the length of hospital stay, simultaneously resulting in higher hospitalization costs 21 . Unfortunately, rehabilitation showed a limited effect in preventing decline of functional status in elderly CAP patients on propensity score analysis.…”

Section: Resultsmentioning

confidence: 99%

Limited Effect of Rehabilitation for Preventing a Decline in Functional Status after Community-Acquired Pneumonia in Elderly Patients

Hao

Horita

et al. 2020

Preprint

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Abstract Background: Functional status is often decreased after hospitalization in elderly community-acquired pneumonia (CAP) survivors. This study investigated factors contributing to decreased functional status.Methods: This retrospective, observational study was conducted in two medical facilities from January 2016 to December 2018. Hospitalized CAP patients >64 years of age were divided into two groups: a maintained group, without decreased functional status, and a decreased group, with decreased functional status. Functional status was evaluated by the Barthel Index (BI) (range, 0–100, in 5-point increments) and graded into three categories: independent, BI 80–100; semi-dependent, BI 30–75; and dependent, BI 0–25. A decreased functional status was considered as a decline of at least one category. The primary outcome was the length of hospital stay. Results: The maintained group included 400 patients, and the decreased group included 138 patients (median age: 77 vs 82 years; p < 0.001). The decreased group had a longer hospital stay (13 vs 27; p<0.001), with a high rate of rehabilitation [189(47.3%) vs 104(75.4%); p<0.001]. Multivariable regression analysis showed that factors affecting functional status were length of hospital stay, aspiration, age, and pneumonia severity index (PSI) category V (odds ratio 1.05, 95%CI 1.04–1.07; 2.66, 95%CI 1.58–4.49; 1.05, 95%CI 1.02–1.09; and 1.92, 95%CI 1.29-3.44; respectively). Rehabilitation showed a limited effect in preventing a decreased functional status on propensity score analysis (p=0.327).Conclusions: Length of hospital stay, aspiration, age, and PSI V were independent contributors to decreased functional status. Rehabilitation showed a limited effect in preventing decreased functional status.

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“…The effects of rehabilitation have been evaluated from various aspects, but there was no de nite conclusion. Some studies showed that early rehabilitation reduced LOS [15,16] in pneumonia, but another study showed that it would prolong LOS [7]. The effects of rehabilitation on mortality and readmission rates were also unclear [17,18].…”

Section: Discussionmentioning

confidence: 99%

“…Decreased FS prolongs length of stay (LOS) in elderly CAP patients [5], and the prevalence of functional decline was reported to be 8.6%-20% in CAP [5,6]. Early rehabilitation therapy might improve activities of daily living (ADL) during hospitalization in patients with aspiration pneumonia, but it may increase LOS [7]. The effect of rehabilitation in preventing decreased FS in CAP has remained unclear.…”

Section: Introductionmentioning

confidence: 99%

Limited effect of rehabilitation for preventing a decrease in functional status after community-acquired pneumonia in elderly patients 

Chen¹,

Hara²,

Horita³

et al. 2020

Preprint

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Background: Functional status (FS) is often decreased after hospitalization in elderly community-acquired pneumonia (CAP) survivors. Rehabilitation has frequently been used to prevent decreased FS. This study was designed to evaluate the effect of rehabilitation for preventing decreased FS.Methods: This retrospective, observational study was conducted in two medical facilities from January 2016 to December 2018, and hospitalized CAP patients >64 years of age were enrolled. FS was assessed by the Barthel Index (BI) (range, 0–100, in 5-point increments) at admission and before discharge and graded into three categories: independent, BI 80–100; semi-dependent, BI 30–75; and dependent, BI 0–25. Multivariable analysis of factors contributing to decreased FS was conducted with two groups: with a decrease of at least one category (decreased group), or without a decrease of a category (maintained group). Then, the effect of rehabilitation was examined by propensity score analysis by adjusting factors contributing to decreased FS determined in the previous multivariable analysis. Results: The maintained group included 400 patients, and the decreased group included 138 patients. The decreased group had a high frequency of rehabilitation therapy (189 (47.3%) vs 104 (75.4%); p<0.001). Multivariable analysis showed that factors affecting FS were length of stay, aspiration pneumonia, age, and Pneumonia Severity Index (PSI) of category V (odds ratio 1.05, 95%CI 1.04–1.07; 2.66, 95%CI 1.58–4.49; 1.05, 95%CI 1.02–1.09; and 1.92, 95%CI 1.29-3.44; respectively). After adjusting for factors contributing to decreased FS, rehabilitation showed a limited effect in preventing a decreased FS in 166 matched pairs (p=0.327).Conclusions: The effect of rehabilitation was still unclear in CAP, and further research is warranted to find an effective way to conduct rehabilitation.

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Effect of early rehabilitation on activities of daily living in patients with aspiration pneumonia

Abstract: The present results suggest that early rehabilitation might improve ADL during hospitalization in patients with aspiration pneumonia. Geriatr Gerontol Int 2016; 16: 1181-1187.

Cited by 23 publications

References 29 publications

Rehabilitative management for aspiration pneumonia in elderly patients

Rehabilitative management for aspiration pneumonia in elderly patients

Limited Effect of Rehabilitation for Preventing a Decline in Functional Status after Community-Acquired Pneumonia in Elderly Patients

Limited effect of rehabilitation for preventing a decrease in functional status after community-acquired pneumonia in elderly patients

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Effect of early rehabilitation on activities of daily living in patients with aspiration pneumonia

Abstract: The present results suggest that early rehabilitation might improve ADL during hospitalization in patients with aspiration pneumonia. Geriatr Gerontol Int 2016; 16: 1181-1187.

Cited by 23 publications

References 29 publications

Rehabilitative management for aspiration pneumonia in elderly patients

Rehabilitative management for aspiration pneumonia in elderly patients

Limited Effect of Rehabilitation for Preventing a Decline in Functional Status after Community-Acquired Pneumonia in Elderly Patients

Limited effect of rehabilitation for preventing a decrease in functional status after community-acquired pneumonia in elderly patients&nbsp;

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Limited effect of rehabilitation for preventing a decrease in functional status after community-acquired pneumonia in elderly patients