Skip to main content

Advertisement

SpringerLink
Log in

Relationships Between Survival and Oral Status, Swallowing Function, and Oral Intake Level in Older Patients with Aspiration Pneumonia

  • Original Article
  • Published:
Dysphagia Aims and scope Submit manuscript

Abstract

The factors affecting the survival of patients with aspiration pneumonia (AP) remain unclear. This study aimed to determine whether factors, including oral status, swallowing function, and oral intake level, were related to survival outcomes in older patients hospitalized for AP. The study enrolled patients with AP who were admitted to our hospital between February 2017 and November 2019. Patients were divided into two groups based on the 90-day mortality after the first swallowing function evaluation: survivors and deceased. The data were compared between the two groups. A total of 29 patients were diagnosed with AP. Of these patients, 13 died within 90 days. The numbers of patients who could not use removable dentures and required sputum suctioning and had cough reflex at rest were significantly higher in the deceased than in the survivors. The salivary pooling and pharyngeal clearance scores evaluated by videoendoscopy, International Dysphagia Diet Standardisation Initiative Functional Diet Scale score determined after swallowing function evaluation, and consciousness level were significantly worse in the deceased than in the survivors. There were significant differences in patients’ oral status, swallowing function, oral intake level, and consciousness level between the survivors and deceased.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ministry of Health, Labor and Welfare. Demographic statistics. https://www.mhlw.go.jp/toukei/list/81-1a.html

  2. Teramoto S, Fukuchi Y, Sasaki H, Sato K, Sekizawa K, Matsuse T. High incidence of aspiration pneumonia in community- and hospital-acquired pneumonia in hospitalized patients: a multicenter, prospective study in Japan. J Am Geriatr Soc. 2008;56:577–9.

    Article  Google Scholar 

  3. Taylor JK, Fleming GB, Singanayagam A, Hill AT, Chalmers JD. Risk factors for aspiration in community-acquired pneumonia: analysis of a hospitalized UK cohort. Am J Med. 2013;126:995–1001.

    Article  Google Scholar 

  4. Takemura K, Yoshimuta Y, Ono T, Kokubo Y, Kida M, Kosaka T, Yasui S, Nokubi T, Maeda Y. The relationship between masticatory ability and food feeding behaviors: the Suita Study. J Jpn Soc Mastication Sci Health Promot. 2013;23:81–9.

    Google Scholar 

  5. Yamamoto H, Furuya J, Tamada Y, Kondo H. Impacts of wearing complete dentures on bolus transport during feeding in elderly edentulous. J Oral Rehabil. 2013;40:923–31.

    Article  CAS  Google Scholar 

  6. Yoshida M, Masuda S, Amano J, Akagawa Y. Immediate effect of denture wearing on swallowing in rehabilitation hospital inpatients. J Am Geriatr Soc. 2013;61:655–7.

    Article  Google Scholar 

  7. Ramos A, Asensio A, Caballos D, Mariño MJ. Prognostic factors associated with community-acquired aspiration pneumonia. Med Clin. 2002;119:81–4.

    Article  Google Scholar 

  8. Kim H, Jo S, Lee JB, Jin Y, Jeong T, Yoon J, Lee JM, Park B. Diagnostic performance of initial serum albumin level for predicting in-hospital mortality among aspiration pneumonia patients. Am J Emerg Med. 2018;36:5–11.

    Article  Google Scholar 

  9. Ryu S, Oh SK, Cho SU, You Y, Park JS, Min JH, Jeong W, Cho YC, Ahn HJ, Kang C. Utility of the blood urea nitrogen to serum albumin ratio as a prognostic factor of mortality in aspiration pneumonia patients. Am J Emerg Med 2020.

  10. Nakashima T, Maeda K, Tahira K, Taniguchi K, Mori K, Kiyomiya H, Akagi J. Silent aspiration predicts mortality in older adults with aspiration pneumonia admitted to acute hospitals. Geriatr Gerontol Int. 2018;18:828–32.

    Article  Google Scholar 

  11. Naruishi K, Nishikawa Y. Swallowing impairment is a significant factor for predicting life prognosis of elderly at the end of life. Aging Clin Exp Res. 2018;30:77–80.

    Article  Google Scholar 

  12. Suzuki R, Kikutani T, Yoshida M, Yamashita Y, Hirayama Y. Prognosis-related factors concerning oral and general conditions for homebound older adults in Japan. Geriatr Gerontol Int. 2015;15:1001–6.

    Article  Google Scholar 

  13. Papadopoulos D, Bader I, Gkioxari E, Petta V, Tsaras T, Galanopoulou N, Archontouli MA, Diamantea F, Kastanakis E, Karagianidis N, Filaditaki V. Microbiology and prognosis assessment of hospitalized patients with aspiration pneumonia: a single-center prospective cohort study. Infez Med. 2018;26:103–14.

    PubMed  Google Scholar 

  14. Kohno S, Imamura Y, Shindo Y, Seki M, Ishida T, Teramoto S, Kadota J, Tomono K, Watanabe A. Clinical practice guidelines for nursing- and healthcare-associated pneumonia (NHCAP) [complete translation]. Respir Investig. 2013;51:103–26.

    Article  Google Scholar 

  15. Eichner K. Renewed examination of the group classification of partially edentulous arches by Eichner and application advices for studies on morbidity statistics. Stomatologie der DDR. 1990;40:321–5.

    CAS  PubMed  Google Scholar 

  16. Belafsky PC, Mouadeb DA, Rees CJ, Pryor JC, Postma GN, Allen J, Leonard RJ. Validity and reliability of the eating assessment tool (EAT-10). Ann Otol Rhinol Laryngol. 2008;117:919–24.

    Article  Google Scholar 

  17. Oguchi K, Saitoh E, Mizuno M, Baba M, Okui M, Suzuki M. The repetitive saliva swallowing test (RSST) as a screening test of functional dysphagia (1) normal values of RSST. Jpn J Rehabil Med. 2000;37:375–82.

    Article  Google Scholar 

  18. Oguchi K, Saitoh E, Baba M, Kusudo S, Tanaka T, Onogi K. The repetitive saliva swallowing test (RSST) as a screening test of functional dysphagia (2) validity of RSST. Jpn J Rehabil Med. 2000;37:383–8.

    Article  Google Scholar 

  19. Wakabayashi H, Kayashita J. Translation, reliability, and validity of the Japanese version of the 10-item Eating Assessment Tool (EAT-10) for the screening of dysphagia. J Jpn Soc Parenter Enter Nutr. 2014;29:871–6.

    Google Scholar 

  20. Hyodo M, Nishikubo K, Hirose K. New scoring proposed for endoscopic swallowing evaluation and clinical significance. Nihon Jibiinkoka Gakkai kaiho. 2010;113:670–8.

    Article  Google Scholar 

  21. 2013 TddcotJSoDR: The Japanese Dysphagia Diet 2013. Jpn J Dysphagia Rehabil 17: 255–267, 2013.

  22. Takata N, Yamagata Y, Kayashita J. A comparison of viscosity classifications between the Japanese Dysphagia diet 2013 criteria and the international dysphagia diet standardisation initiative. 2017.

  23. Langmore S, Pelletier C, Nelson R. Results of FEES survey on safety of endoscopy for swallowing assessment. Presented at Fourth Annual Meeting of the Dysphagia Research Society, McLean, VA, October 28, 1995.

  24. Crary MA, Mann GDC, Groher ME. Initial psychometric assessment of a functional oral intake scale for dysphagia in stroke patients. Arch Phys Med Rehabil. 2005;86:1516–20.

    Article  Google Scholar 

  25. Steele CM, Namasivayam-MacDonald AM, Guida BT, Cichero JA, Duivestein J, Hanson B, Lam P, Riquelme LF. Creation and initial validation of the international dysphagia diet standardisation initiative functional diet scale. Arch Phys Med Rehabil. 2018;99:934–44.

    Article  Google Scholar 

  26. Ohta T, Waga S, Handa W, Saito I, Takeuchi K. New grading of level of disordered consiousness (author’s transl). No shinkei geka Neurol Surg. 1974;2:623–7.

    CAS  PubMed  Google Scholar 

  27. Mortensen EM, Coley CM, Singer DE, Marrie TJ, Obrosky DS, Kapoor WN, Fine MJ. Causes of death for patients with community-acquired pneumonia: Results from the pneumonia patient outcomes research team cohort study. Arch Int Med. 2002;162:1059–64.

    Article  Google Scholar 

  28. Maeda K, Akagi J. Muscle Mass Loss Is a Potential Predictor of 90-Day Mortality in Older Adults with Aspiration Pneumonia. J Am Geriatr Soc. 2017;65:e18–22.

    Article  Google Scholar 

  29. Avivi-Arber L, Sessle BJ. Jaw sensorimotor control in healthy adults and effects of ageing. J Oral Rehabil. 2018;45:50–80.

    Article  CAS  Google Scholar 

  30. Cera ML, Ortiz KZ, Bertolucci PH, Minett TS. Speech and orofacial apraxias in Alzheimer’s disease. Int Psychogeriatr. 2013;25:1679–85.

    Article  Google Scholar 

  31. Taji T, Yoshida M, Hiasa K, Abe Y, Tsuga K, Akagawa Y. Influence of mental status on removable prosthesis compliance in institutionalized elderly persons. Int J Prosthodont. 2005;18:146–9.

    PubMed  Google Scholar 

  32. Chiba Y, Sano D, Ikui Y, Nishimura G, Yabuki K, Arai Y, Tanabe T, Ikemiyagi H, Hyakusoku H, Oridate N. Predictive value of the Hyodo score in endoscopic evaluation of aspiration during swallowing. Auris Nasus Larynx. 2018;45:1214–20.

    Article  Google Scholar 

  33. Clavé P, de Kraa M, Arreola V, Girvent M, Farré R, Palomera E, Serra-Prat M. The effect of bolus viscosity on swallowing function in neurogenic dysphagia. Aliment Pharmacol Ther. 2006;24:1385–94.

    Article  Google Scholar 

  34. Onodera S, Furuya J, Yamamoto H, Tamada Y, Kondo H. Effects of wearing and removing dentures on oropharyngeal motility during swallowing. J Oral Rehabil. 2016;43:847–54.

    Article  CAS  Google Scholar 

  35. Yoshikawa M, Yoshida M, Nagasaki T, Tanimoto K, Tsuga K, Akagawa Y. Influence of aging and denture use on liquid swallowing in healthy dentulous and edentulous older people. J Am Geriatr Soc. 2006;54:444–9.

    Article  Google Scholar 

  36. Rofes L, Arreola V, Mukherjee R, Clavé P. Sensitivity and specificity of the eating assessment tool and the volume-viscosity swallow test for clinical evaluation of oropharyngeal dysphagia. Neurogastroenterol Motil. 2014;26:1256–65.

    Article  CAS  Google Scholar 

  37. Hu X, Yi ES, Ryu JH. Aspiration-related deaths in 57 consecutive patients: autopsy study. PLoS ONE. 2014;9:e103795.

    Article  Google Scholar 

  38. Nishino T, Honda Y, Kohchi T, Shirahata M, Yonezawa T. Effects of increasing depth of anaesthesia on phrenic nerve and hypoglossal nerve activity during the swallowing reflex in cats. Br J Anaesth. 1985;57:208–13.

    Article  CAS  Google Scholar 

  39. Teramoto S, Matsuse T, Oka T, Ito H, Fukuchi Y, Ouchi Y. Investigation of effects of anesthesia and age on aspiration in mice through LacZ gene transfer by recombinant E1-deleted adenovirus vectors. Am J Respir Crit Care Med. 1998;158:1914–9.

    Article  CAS  Google Scholar 

  40. Sato M, Tohara H, Iida T, Wada S, Inoue M, Ueda K. Simplified cough test for screening silent aspiration. Arch Phys Med Rehabil. 2012;93:1982–6.

    Article  Google Scholar 

Download references

Acknowledgements

The authors thank Alison Sherwin, PhD, from Edanz Group (https://en-author-services.edanzgroup.com/ac) for editing a draft of this manuscript.

Author information

Authors and Affiliations

  1. Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan

    Taku Suzuki, Takanori Tsujimura, Jin Magara, Naohito Hao, Naru Shiraishi & Makoto Inoue

  2. Minamiuonuma City Hospital, 2643-1 Muika-machi, Minamiuonuma-shi, Niigata, 949-6680, Japan

    Taku Suzuki

  3. Minamiuonuma City Yukiguni Yamato Hospital, 4115 Urasa, Minamiuonuma-shi, Niigata, 949-7302, Japan

    Taku Suzuki, Naohito Hao, Naru Shiraishi, Kazuya Maekawa & Kazuo Matsushima

  4. Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai-shi, Miyagi, 980-8575, Japan

    Naru Shiraishi

  5. Niigata Minami Hospital, 2007-6 Toyano, Chuo-ku, Niigata, 950-8601, Japan

    Kazuya Maekawa

Authors
  1. Taku Suzuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Takanori Tsujimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jin Magara
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Naohito Hao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Naru Shiraishi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kazuya Maekawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kazuo Matsushima
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Makoto Inoue
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Taku Suzuki.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to report.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Suzuki, T., Tsujimura, T., Magara, J. et al. Relationships Between Survival and Oral Status, Swallowing Function, and Oral Intake Level in Older Patients with Aspiration Pneumonia. Dysphagia 37, 558–566 (2022). https://doi.org/10.1007/s00455-021-10306-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00455-021-10306-3

Keywords

Search

Navigation