Characteristics of Swallowing Function in the Very Elderly and Risk Factors of Aspiration Pneumonia

Background: Frailty is associated with higher risk of cardiovascular disease (CVD) and mortality. Recently, oral hypofunction, a disease in which the oral function is complexly reduced not only by ageing but also by a variety of factors, is regarded as a major risk factor for frailty, as it develops malnutrition and sarcopenia. However, no studies have evaluated the association of oral hypofunction and arterial stiffness, a marker for CVD. Hypothesis: We hypothesized that subjects with oral hypofunction have increased arterial stiffness compared to those without oral hypofunction. Methods: Japanese subjects above 50 years old who underwent annual health checkup were enrolled in this cross-sectional study. Subjects with history of CVD and dementia were excluded. Arterial stiffness was evaluated by brachial-ancle pulse wave velocity (baPWV). Oral hypofunction was evaluated based on the guidance by the Japanese Association for Dental Science. Seven oral factors, oral hygiene, oral moisture, occlusal force, tongue-lip motor function, tongue pressure, masticatory function, and swallowing function were assessed. Oral hypofunction was diagnosed if more than 3 factors showed deterioration. The association of oral hypofunction and baPWV was evaluated by multivariate linear regression analysis adjusted for conventional CVD risk factors. We also performed subgroup analysis stratified by age. (<60, ≧60 years). Results: Among 148 subjects (mean age: 59±7 years), 34 subjects (23%) had oral hypofunction. BaPWV in subjects with oral hypofunction was significantly higher than subjects without oral hypofunction (mean baPWV: 1539±312 v.s. 1416±260cm/sec, p=0.02). However, after adjustment for CVD risk factors, oral hypofunction did not significantly associate with baPWV (β=46±49, p=0.35). On the other hand, in subgroup analysis, oral hypofunction was significantly associated with increased baPWV among subjects in subjects younger than 60 years old even after adjustment of CVD risk factors (β=135±67, p=0.046), but this association was not observed in subjects over 60s. Conclusion: Oral hypofunction was associated with increased arterial stiffness, especially in subjects younger than 60s. Further research on oral hypofunction and CVD is warranted.

Download Full-text

Gross motor dysfunction as a risk factor for aspiration pneumonia in children with cerebral palsy

Paediatrica Indonesiana ◽

10.14238/pi57.5.2017.229-33 ◽

2018 ◽

Vol 57 (5) ◽

pp. 229 ◽

Cited By ~ 1

Author(s):

Cut Nurul Hafifah ◽

Darmawan Budi Setyanto ◽

Sukman Tulus Putra ◽

Irawan Mangunatmadja ◽

Teny Tjitra Sari ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Cerebral Palsy ◽

Aspiration Pneumonia ◽

Motor Dysfunction ◽

Silent Aspiration ◽

Gross Motor ◽

Respiratory Problems ◽

Children With Cerebral Palsy ◽

Chest X Ray

Background Respiratory problems, such as aspiration pneumonia, are major causes of morbidity and mortality in children with cerebral palsy (CP) and greatly affect the quality of life of these children. Nevertheless, there is limited data on the incidence and risk factors of aspiration pneumonia in children with CP in Indonesia. Objective To determine the incidence and risk factors of aspiration pneumonia in children with cerebral palsy.Methods In children with CP aged 1-18 years, incidence of pneumonia was studied prospectively for 6 months and the prevalence of the risk factors was studied cross-sectionally. At baseline, we evaluated subjects’ by history-taking, physical examination, risk factors, and chest X-ray to assess the incidence of silent aspiration. Subjects were followed-up for six months to determine the incidence of overt or silent aspiration pneumonia.Results Eight out of 36 subjects had one or more episodes of aspiration, consisting of silent aspiration (2/36) and clinically diagnosed aspiration pneumonia (7/36). Subjects with more severe gross motor dysfunction experienced more episodes aspiration pneumonia, although it was not statistically significant (p = 0.06), while dysphagia (P=0.2) and nutritional status (P=0.11) were not associated with pneumonia or silent aspiration.Conclusion Twenty-five percent of children with CP experienced aspiration pneumonia during the 6-month study period, with gross motor dysfunction as a possible risk factor.

Download Full-text

Stroke about very elderly patients in West African Country (Niger): Prognosis risk factors

10.30574/ijsra.2021.2.1.0001 ◽

2021 ◽

Vol 2 (1) ◽

pp. 006-011

Author(s):

Andia Abdoulkader ◽

Garba Abdoul Aziz ◽

Idrissa Hama ◽

Larent Youmbi ◽

Brah Souleymane

Keyword(s):

Risk Factors ◽

Elderly Patients ◽

Multidisciplinary Approach ◽

Hemorrhagic Stroke ◽

African Country ◽

Neurovascular Unit ◽

West African ◽

Medical Emergency ◽

Very Elderly ◽

Nihss Score

Background: Chronic diseases such as stroke most frequently occur on old people while literature on prognosis risk factors on elderly is rare particularly Sub-Sahara Africa. The aim of the study is to determine prognosis risk factors of stroke on elderly patients. Method: It was a prospective cohort study carried out during 6 months that included elderly patients over 70 years old admitted in two tertiary medical emergency departments. Results: 56 patients with mean age 75.2 ± 5.17 showed moderate NIHSS score (59%) without gender predominance. 75% of patients with a severe score were in the 70-79 years old group. Functional dependency (93%) increased with the NIHSS score severity and 50% of patients with a moderate NIHSS score showed normal nutritional status unlike patients with a severe NIHSS score and depression for most of the cases. Mortality was frequent for patients with hemorrhagic stroke with swallowing disorder and a severe NIHSS score. Conclusion: Stroke on very elderly patients appears moderate with mortality chances increasing according to the severity of the NIHSS score, swallowing disorders that require a multidisciplinary approach in a neurovascular unit.

Download Full-text

Assessment of the Risk Factors for Aspiration Pneumonia During Chemoradiotherapy for Head and Neck Cancer

Koutou (THE LARYNX JAPAN) ◽

10.5426/larynx.30.18 ◽

2018 ◽

Vol 30 (1) ◽

pp. 18-22

Author(s):

Machiko Ogawa ◽

Tomokazu Yoshizaki

Keyword(s):

Risk Factors ◽

Head And Neck Cancer ◽

Head And Neck ◽

Aspiration Pneumonia ◽

Neck Cancer

Download Full-text

Risk Factors for Aspiration Pneumonia after Percutaneous Endoscopic Gastrostomy

Gerontology ◽

10.1159/000100898 ◽

2007 ◽

Vol 53 (4) ◽

pp. 224-227 ◽

Cited By ~ 18

Author(s):

Toshiro Kitamura ◽

Hajime Nakase ◽

Hidehiko Iizuka

Keyword(s):

Risk Factors ◽

Aspiration Pneumonia ◽

Percutaneous Endoscopic Gastrostomy ◽

Endoscopic Gastrostomy

Download Full-text

Poor outcome of octogenarians admitted to ICU due to periprosthetic joint infections: a retrospective cohort study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03331-0 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Emre Yilmaz ◽

Alexandra Poell ◽

Hinnerk Baecker ◽

Sven Frieler ◽

Christian Waydhas ◽

...

Keyword(s):

Risk Factors ◽

Elderly Patients ◽

Joint Infection ◽

Invasive Ventilation ◽

Very Elderly ◽

Saps Ii ◽

Poor Outcome ◽

Joint Infections ◽

Saps Ii Score ◽

The Mean

Abstract Background Even though surgical techniques and implants have evolved, periprosthetic joint infection (PJI) remains a serious complication leading to poor postoperative outcome and a high mortality. The literature is lacking in studies reporting the mortality of very elderly patients with periprosthetic joint infections, especially in cases when an intensive care unit (ICU) treatment was necessary. We therefore present the first study analyzing patients with an age 80 and higher suffering from a periprosthetic joint infection who had to be admitted to the ICU. Methods All patients aged 80 and higher who suffered from a PJI (acute and chronic) after THR or TKR and who have been admitted to the ICU have been included in this retrospective, observational, single-center study. Results A total of 57 patients met the inclusion criteria. The cohort consisted of 24 males and 33 females with a mean age of 84.49 (± 4.0) years. The mean SAPS II score was 27.05 (± 15.7), the mean CCI was 3.35 (± 2.28) and the most patient had an ASA score of 3 or higher. The PJI was located at the hip in 71.9% or at the knee in 24.6%. Two patients (3.5%) suffered from a PJI at both locations. Sixteen patients did not survive the ICU stay. Non-survivors showed significantly higher CCI (4.94 vs. 2.73; p = 0.02), higher SAPS II score (34.06 vs. 24.32; p = 0.03), significant more patients who underwent an invasive ventilation (132.7 vs. 28.1; p = 0.006) and significantly more patients who needed RRT (4.9% vs. 50%; p < 0.001). In multivariate analysis, RRT (odds ratio (OR) 15.4, CI 1.69–140.85; p = 0.015), invasive ventilation (OR 9.6, CI 1.28–71.9; p = 0.028) and CCI (OR 1.5, CI 1.004–2.12; p = 0.048) were independent risk factors for mortality. Conclusion Very elderly patients with PJI who needs to be admitted to the ICU are at risk to suffer from a poor outcome. Several risk factors including a chronic infection, high SAPS II Score, high CCI, invasive ventilation and RRT might be associated with a poor outcome.

Download Full-text