TY - JOUR
T1 - Food bolus-forming ability predicts incidence of aspiration pneumonia in nursing home older adults
T2 - A prospective observational study
AU - Hase, Takashi
AU - Miura, Yuka
AU - Nakagami, Gojiro
AU - Okamoto, Shigefumi
AU - Sanada, Hiromi
AU - Sugama, Junko
N1 - Funding Information:
This work was partially supported by JSPS KAKENHI Grant Number 18K17714. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2019 John Wiley & Sons Ltd
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Background: Food boluses in the pharynx without enough bolus formation sometimes cause aspiration among older adults; however, the relationship between food bolus-forming ability and incidence of aspiration pneumonia is unclear. Objective: To investigate the relationship between food bolus-forming ability and incidence of aspiration pneumonia by evaluating the condition of chew-swallow managing food transported into the pharynx. Methods: A prospective observational study conducted in a nursing home for the elderly between April 2016 and February 2018. Seventy-three residents who swallowed thickened liquids and consistent boluses without aspiration were included. Food boluses were graded into three categories in the pharynx using videoendoscopic evaluation. Boluses that retained their original shape were defined as Grade 1. A mixture of large and small boluses was defined as Grade 2. Boluses that had completely transformed into a paste were defined as Grade 3. The relationship between the bolus formation grade and incidence of aspiration pneumonia over 6-month follow-up was investigated. Results: Seventeen residents developed aspiration pneumonia. The incidence rate of aspiration pneumonia was highest among residents with Grade 1 boluses, at an incidence rate of.187 cases per person-month (95% confidence interval (CI): 0.097-0.359). Cox regression showed residents with Grade 1 boluses had a hazard ratio of 4.548 (1.393-14.85) for incidence of aspiration pneumonia compared with residents who had Grade 2 or 3 boluses. Conclusion: Insufficient food bolus-forming ability predicted high incidence of aspiration pneumonia. Healthcare professionals should evaluate the food bolus-forming ability, as well as swallowing function, to prevent aspiration pneumonia.
AB - Background: Food boluses in the pharynx without enough bolus formation sometimes cause aspiration among older adults; however, the relationship between food bolus-forming ability and incidence of aspiration pneumonia is unclear. Objective: To investigate the relationship between food bolus-forming ability and incidence of aspiration pneumonia by evaluating the condition of chew-swallow managing food transported into the pharynx. Methods: A prospective observational study conducted in a nursing home for the elderly between April 2016 and February 2018. Seventy-three residents who swallowed thickened liquids and consistent boluses without aspiration were included. Food boluses were graded into three categories in the pharynx using videoendoscopic evaluation. Boluses that retained their original shape were defined as Grade 1. A mixture of large and small boluses was defined as Grade 2. Boluses that had completely transformed into a paste were defined as Grade 3. The relationship between the bolus formation grade and incidence of aspiration pneumonia over 6-month follow-up was investigated. Results: Seventeen residents developed aspiration pneumonia. The incidence rate of aspiration pneumonia was highest among residents with Grade 1 boluses, at an incidence rate of.187 cases per person-month (95% confidence interval (CI): 0.097-0.359). Cox regression showed residents with Grade 1 boluses had a hazard ratio of 4.548 (1.393-14.85) for incidence of aspiration pneumonia compared with residents who had Grade 2 or 3 boluses. Conclusion: Insufficient food bolus-forming ability predicted high incidence of aspiration pneumonia. Healthcare professionals should evaluate the food bolus-forming ability, as well as swallowing function, to prevent aspiration pneumonia.
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U2 - 10.1111/joor.12861
DO - 10.1111/joor.12861
M3 - Article
C2 - 31299094
AN - SCOPUS:85071075086
VL - 47
SP - 53
EP - 60
JO - Journal of Oral Rehabilitation
JF - Journal of Oral Rehabilitation
SN - 0305-182X
IS - 1
ER -