Dysphagia

, Volume 13, Issue 2, pp 69–81

Predictors of Aspiration Pneumonia: How Important Is Dysphagia?

  • Susan E.  Langmore
  • Margaret S.  Terpenning
  • Anthony  Schork
  • Yinmiao  Chen
  • Joseph T.  Murray
  • Dennis  Lopatin
  • Walter J.  Loesche

DOI: 10.1007/PL00009559

Cite this article as:
Langmore, S., Terpenning, M., Schork, A. et al. Dysphagia (1998) 13: 69. doi:10.1007/PL00009559

Abstract.

Aspiration pneumonia is a major cause of morbidity and mortality among the elderly who are hospitalized or in nursing homes. Multiple risk factors for pneumonia have been identified, but no study has effectively compared the relative risk of factors in several different categories, including dysphagia. In this prospective outcomes study, 189 elderly subjects were recruited from the outpatient clinics, inpatient acute care wards, and the nursing home care center at the VA Medical Center in Ann Arbor, Michigan. They were given a variety of assessments to determine oropharyngeal and esophageal swallowing and feeding status, functional status, medical status, and oral/dental status. The subjects were followed for up to 4 years for an outcome of verified aspiration pneumonia. Bivariate analyses identified several factors as significantly associated with pneumonia. Logistic regression analyses then identified the significant predictors of aspiration pneumonia. The best predictors, in one or more groups of subjects, were dependent for feeding, dependent for oral care, number of decayed teeth, tube feeding, more than one medical diagnosis, number of medications, and smoking. The role that each of the significant predictors might play was described in relation to the pathogenesis of aspiration pneumonia. Dysphagia was concluded to be an important risk for aspiration pneumonia, but generally not sufficient to cause pneumonia unless other risk factors are present as well. A dependency upon others for feeding emerged as the dominant risk factor, with an odds ratio of 19.98 in a logistic regression model that excluded tube-fed patients.

Key words: Pneumonia — Aspiration — Functional status — Medical, oral, dental status — Deglutition — Deglutition disorders. 

Copyright information

© Springer-Verlag New York Inc. 1998

Authors and Affiliations

  • Susan E.  Langmore
    • 1
  • Margaret S.  Terpenning
    • 1
  • Anthony  Schork
    • 4
  • Yinmiao  Chen
    • 4
  • Joseph T.  Murray
    • 1
  • Dennis  Lopatin
    • 5
  • Walter J.  Loesche
    • 5
  1. 1.Veterans Affairs Medical Center, Ann Arbor, Michigan, USAUS
  2. 2.School of Dentistry, Department of Oral Medicine, Pathology, and Surgery, University of Michigan, Ann Arbor, Michigan, USAUS
  3. 3.School of Medicine, Department of Internal Medicine, Division of Geriatric Medicine, University of Michigan, Ann Arbor, Michigan, USAUS
  4. 4.School of Public Health, University of Michigan, Ann Arbor, Michigan, USAUS
  5. 5.School of Dentistry, Department of Biologic and Materials Science, University of Michigan, Ann Arbor, Michigan, USAUS

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