Masuda H, Ueha R, Sato T, Goto T, Koyama M, Yamauchi A, Kaneoka A, Suzuki S, Yamasoba T. Risk Factors for Aspiration Pneumonia After Receiving Liquid-Thickening Recommendations.
Otolaryngol Head Neck Surg 2021;
167:125-132. [PMID:
34582292 PMCID:
PMC9251747 DOI:
10.1177/01945998211049114]
[Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objective
We examined the influence of liquid thickness levels on the frequency of
liquid penetration-aspiration in patients with dysphagia and evaluated the
clinical risk factors for penetration-aspiration and aspiration pneumonia
development.
Study Design
A case series.
Setting
Single-institution academic center.
Methods
We reviewed medical charts from 2018 to 2019. First, we evaluated whether
liquid thickness levels influence the frequency of liquid
penetration-aspiration in patients with dysphagia. Penetration-aspiration
occurrence in a videofluoroscopic swallowing study was defined as
Penetration-Aspiration Scale (PAS) scores ≥3. Second, the association
between liquid thickness level and penetration-aspiration was analyzed, and
clinical risk factors were identified. Moreover, clinical risk factors for
aspiration pneumonia development within 6 months were investigated.
Results
Of 483 patients, 159 showed penetration-aspiration. The thickening of liquids
significantly decreased the incidence of penetration-aspiration
(P < .001). Clinical risk factors for
penetration-aspiration were vocal fold paralysis (odds ratio [OR], 1.99),
impaired laryngeal sensation (OR, 5.01), and a history of pneumonia (OR,
2.90). Twenty-three patients developed aspiration pneumonia while
undertaking advised dietary changes, including liquid thickening.
Significant risk factors for aspiration pneumonia development were poor
performance status (OR, 1.85), PAS score ≥3 (OR, 4.03), and a history of
aspiration pneumonia (OR, 7.00).
Conclusion
Thickening of liquids can reduce the incidence of penetration-aspiration.
Vocal fold paralysis, impaired laryngeal sensation, and history of
aspiration pneumonia are significant risk factors of penetration-aspiration.
Poor performance status, PAS score ≥3, and history of aspiration pneumonia
are significantly associated with aspiration pneumonia development following
recommendations on thickening liquids.
Level of Evidence
3.
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