scholarly journals A Retrospective Survey on Hospital Stay of Patients Admitted with Aspiration Pneumonia in Association with Swallowing Function Assessment in Nagoya Memorial Hospital

2018 ◽  
Vol 44 (1) ◽  
pp. 8-14
Author(s):  
Chiharu Okamoto ◽  
Miki Iwasaki ◽  
Mayumi Matsushima ◽  
Kenji Ina ◽  
Megumi Kabeya ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Aspiration Pneumonia ◽  
Memorial Hospital ◽  
Swallowing Function ◽  
Retrospective Survey ◽  
Function Assessment

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

2020 ◽  
Vol 71 (2) ◽  
pp. 221-221
Author(s):  
T. Karaho ◽  
K. Kawahara ◽  
T. Ebihara ◽  
K. Saito
Keyword(s):  
Risk Factors ◽  
Aspiration Pneumonia ◽  
Very Elderly ◽  
Swallowing Function

Proactive versus reactive feeding tube (FT) placement in head and neck cancer patients (HNC pts) receiving chemoradiation (CRT).

2019 ◽  
Vol 37 (31_suppl) ◽  
pp. 11-11
Author(s):  
Thunnisa Sivananth ◽  
Maureen Quinn ◽  
Rae-Ann Stortz ◽  
David A. Palma ◽  
Peggy Francis ◽  
...  
Keyword(s):  
Weight Loss ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Treatment Interruption ◽  
Feeding Tube ◽  
Nutritional Management ◽  
Swallowing Function ◽  
Platinum Based Chemotherapy ◽  
Optimal Approach ◽  
The Impact

11 Background: Most HNC pts treated with CRT develop severe treatment-related oropharyngeal mucositis. For pts with adequate nutritional status and swallowing function prior to CRT the optimal approach to nutritional management remains undefined. A subset of pts will require FTs to complete treatment, but at least 50% of pts with prophylactic FTs never use them (Madhoun 2011). At our center we have used a "reactive" approach which minimizes exposure to unnecessary FT placement. However, some pts suffer nutritional crises resulting in hospitalization, treatment interruption, and higher risks of complications from FT placement. We investigated the impact of a more proactive approach to FT placement in our pts. Methods: HNC pts treated with CRT who received a FT during treatment 2014-2018 were retrospectively identified from electronic medical records and clinical data extracted. "Proactive" FTs were not considered medically necessary but were placed within 15 days of starting CRT. Primary outcomes of interest were weight loss during CRT (WTL), FT complications, length of hospital stay and FT duration. Uni- and multivariate analyses were done and p values < 0.05 considered of interest. Results: 124 pts were identified: 87% male, median age 62.5 yrs (39-80) and 67% oropharyngeal primary. All received platinum-based chemotherapy or cetuximab (8 pts). 19 FTs were considered medically necessary, 94 were placed reactively and 11 placed proactively; 91% were percutaneous and 94% were used. Median weight was 79.0 kg (27.6-165.7) prior to CRT and 71.2 kg (26.8-148.2) after. Median WTL was 9.9% (-13.9 to 33.3%). Proactive FT placement was associated with less WTL (p = 0.045). WTL was greater in pts over age 65 (OR 11.6 [1.4-97.6]). Hospital stay was longer for pts who had reactive FT. Females had longer FT duration (p = 0.005). Conclusions: These data suggest that when a reactive approach to FT placement is used, earlier FT placement during CRT is more effective at reducing weight loss and hospitalization time in this population. Specific criteria for pt selection with this approach should be defined. Further research to define the optimal approach to nutritional management in HNC pts receiving CRT is needed.

scholarly journals Usefulness of the Modified Videofluoroscopic Dysphagia Scale in Evaluating Swallowing Function among Patients with Amyotrophic Lateral Sclerosis and Dysphagia

2021 ◽  
Vol 10 (19) ◽  
pp. 4300
Author(s):  
Byung Joo Lee ◽  
Hyoshin Eo ◽  
Donghwi Park
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Aspiration Pneumonia ◽  
Roc Curve ◽  
Oral Feeding ◽  
Roc Curve Analysis ◽  
Swallowing Function ◽  
Feeding Method ◽  
Long Term Prognosis ◽  
Lateral Sclerosis

Introduction: The videofluoroscopic dysphagia scale (VDS) is used to predict the long-term prognosis of dysphagia among patients with the condition. Previously, a modified version of the VDS (mVDS) was established to overcome the relatively low inter-rater reliability of VDS, and was verified in patients with dysphagia, such as stroke patients. However, the validity of mVDS in patients with amyotrophic lateral sclerosis (ALS) has never been proved. Therefore, in this study, we attempted to seek the validity of the mVDS score in patients with ALS suffering from dysphagia. Method: Data from the videofluoroscopic swallowing study (VFSS) of 34 patients with ALS and dysphagia were retrospectively collected. We investigated the presence of aspiration pneumonia and the selected feeding method based on the VFSS. We also evaluated the correlations between the mVDS and the selected feeding method, and between the mVDS and the presence of aspiration pneumonia. Multivariate logistic regression and receiver operating characteristic (ROC) analyses were performed during the data analysis. Results: In patients with ALS and dysphagia, the mVDS scores were statistically correlated with the selected feeding method (p < 0.05) and the presence of aspiration pneumonia (p < 0.05). In the ROC curve analysis, the area under the ROC curve values for the selected feeding method and the presence of aspiration pneumonia were 0.886 (95% confidence interval (CI), 0.730–0.969; p < 0.0001) and 0.886 (95% CI, 0.730–0.969; p < 0.0001), respectively. Conclusion: The mVDS can be a useful tool for quantifying the severity of dysphagia and interpreting the VFSS findings in patients with ALS and dysphagia. However, further studies involving a more general population of patients with ALS are needed to elucidate a more accurate cut-off value for the allowance of oral feeding and the presence of aspiration pneumonia.

MON-PO423: Predictive Factors for Improvement of Swallowing Function in Patients with Aspiration Pneumonia

2019 ◽  
Vol 38 ◽  
pp. S215
Author(s):  
M. Sato ◽  
Y. Ogawa ◽  
N. Atsushi ◽  
I. Motoaki ◽  
K. Masanori ◽  
...  
Keyword(s):  
Aspiration Pneumonia ◽  
Predictive Factors ◽  
Swallowing Function

scholarly journals Dental Hygienists’ Practice in Perioperative Oral Care Management According to the Japanese Dental Hygienists Survey 2019

2020 ◽  
Vol 18 (1) ◽  
pp. 114
Author(s):  
Yoshiaki Nomura ◽  
Yuki Ohara ◽  
Yuko Yamamoto ◽  
Ayako Okada ◽  
Noriyasu Hosoya ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Care Management ◽  
Oral Care ◽  
Care Practice ◽  
Dental Hygienists ◽  
Swallowing Function ◽  
Dental Clinics ◽  
Systemic Health ◽  
Mouth Rinsing

Perioperative oral care management is effective in the prevention of postoperative complications, and dental hygienists play an important role. The aim of this study was to elucidate the practice and substantial role of dental hygienists in perioperative oral care management. The Japan Dental Hygienists Association conducted a survey of the employment status of Japanese dental hygienists in 2019. Questionnaires were distributed to all 16,722 members, and 8932 were returned (collection rate: 53.4%). A total of 3560 dental hygienists were working at dental clinics and 1450 (38.2%) were performing perioperative oral care management. More than 90% of them implemented conventional oral care practice. Less than half of the dental hygienists implemented treatment concerning oral functions. Only 9.9% of dental hygienists recognized shortened hospital stay as an effect of perioperative oral care management. Dental hygienists who implemented both nutritional instruction and training of swallowing function or mouth rinsing instructions recognized the shortened hospital stay effect. Overall implementation of perioperative oral care management led to shortened hospital stay. Implementation of perioperative oral care management required knowledge and skills related to systemic health conditions. A stepwise educational program is necessary for perioperative oral care management to become commonplace for dental hygienists.

scholarly journals Risk of aspiration pneumonia in paediatric patients with dysphagia who were found to have laryngeal penetration on the instrumental swallow evaluation: a systematic review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e048422
Author(s):  
Vaishali Adlakha ◽  
Leona Ramos ◽  
Abigail Smith ◽  
Olivia Tsistinas ◽  
Emily Tanner-Smith ◽  
...  
Keyword(s):  
Systematic Review ◽  
Aspiration Pneumonia ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Swallowing Function ◽  
Assessment Development ◽  
Increased Risk ◽  
Laryngeal Penetration ◽  
Risk Of Aspiration ◽  
Tracheal Aspiration

IntroductionDysphagia affects several children in USA and around the globe. Videofluoroscopic Swallow Study (VFSS) and Fiberoptic Endoscopic Evaluation of Swallowing (FEES) are the most objective studies to define swallowing function. The presence of tracheal aspiration during VFSS or FEES in children with dysphagia is associated with an increased risk of aspiration pneumonia. However, the association of laryngeal penetration with aspiration pneumonia remains unclear. This systematic review aims to assess the risk of aspiration pneumonia in children with dysphagia with laryngeal penetration on VFSS/FEES and compare it with children with tracheal aspiration and children with neither tracheal aspiration nor laryngeal penetration.Methods and analysisThis study will be a systematic review and meta-analysis. Systematic electronic searches will be conducted on PubMed, EMBASE, Web of Science, CINHAL, Scopus, Cochrane CENTRAL, LILACS and WHO Global Index Medicus. We will include studies published through 6 October 2021. Primary outcome will be the incidence of aspiration pneumonia. Secondary outcomes will be incidence of hospitalisation, paediatric intensive care unit admission, enteral tube requirement, growth, symptoms improvement and mortality. The Cochrane Risk of Bias In Non-Randomised Studies of Interventions tool will be used to assess the risk of bias. Meta-analysis will be used to pool the studies. We will pool dichotomous outcomes to obtain an odd ratio (OR) and report with 95% CI. Continuous outcomes will be pooled to obtain mean difference and reported with 95% CI. Overall grade of evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, and findings will be presented in a summary of findings table.Ethics and disseminationThis study is a systematic review without contact with patients. Therefore, IRB approval is not required. Authors consent to publishing this review. Data will be kept for review by editors and peer reviewers. Data will be available to general public on request.PROSPERO registration numberCRD42020222145.

scholarly journals Press needle for the Prevention of Aspiration Pneumonia in Elderly People: Study Protocol for a Randomized Double-Blind Placebo-Controlled trial.

2021 ◽  
Author(s):  
Soichiro Kaneko ◽  
Akiko Kikuchi ◽  
Shin Takayama ◽  
Ryutaro Arita ◽  
Yumika Seki ◽  
...  
Keyword(s):  
Elderly People ◽  
Aspiration Pneumonia ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Lower Limbs ◽  
Secondary Outcome ◽  
Swallowing Function ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Investigation Period

Abstract Background: Pneumonia is the fifth most common cause of death among the Japanese, with 97% of deaths occurring among elderly people aged 65 years or older. The incidence ratio of aspiration pneumonia is high for elderly people. Therefore, prophylaxis is important in geriatric medicine. In our previous studies, we reported that stimulation to the acupoints at ST36 and KI3 of the lower limbs with press needle improved the swallowing function of patients with dysphagia. The improvement of swallowing function may prevent aspiration pneumonia. The aim of this study is to investigate the protective efficacy of using press needle stimulation in the lower limbs for aspiration pneumonia.Methods/design: This is a multi-center, randomized double-blind placebo-controlled trial. A total of 140 patients with cerebrovascular disorder with a history of aspiration pneumonia will be recruited from six centers and randomly assigned to either the real press needle group or the sham press needle group in a 1:1 ratio. The press needle will be replaced twice a week. Treatment will be administered bilaterally at acupoints ST36 and KI3. The primary outcome is the frequency of onset of aspiration pneumonia. The secondary outcome is improvement of the latent time of swallowing reflex (LTSR). The investigation period is of 12-month. The primary outcome will be evaluated throughout the period, and secondary outcomes will be assessed at baseline, 1st month, 6th month, and at the end of the investigation period.Discussion: This study will evaluate the effects of press needle on prevention of aspiration pneumonia and improvement of swallowing function of patients. The results of this study will help support the prophylaxis of aspiration pneumonia.Trial registration: UMIN000023123, registered on July 12th, 2016; https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000026460

scholarly journals Dysphagia and associated pneumonia in stroke patients from India

2020 ◽  
Author(s):  
Rahul Krishnamurthy ◽  
Priya Karimuddanahally Premkumar ◽  
Radish Kumar Balasubramanium
Keyword(s):  
Hospital Stay ◽  
Aspiration Pneumonia ◽  
Data Extraction ◽  
Calculated Data ◽  
Length Of Hospital Stay ◽  
Pulmonary Complications ◽  
Sound Studies ◽  
Stroke Patients ◽  
Relative Risks ◽  
High Incidence

AbstractBackgroundIndia has high incidence (116-163 per 100,000) of stroke compared to western countries. Stroke is reported to be the fourth leading cause of death and fifth leading cause of disability in India. Dysphagia is seen approximately in half of the stroke patients and if unidentified may result in pulmonary complications such as aspiration pneumonia. However, there is no estimate of post stroke dysphagia and associated pneumonia in India.MethodUsing the PRISMA methodology, a systematic search for recent literature on dysphagia in stroke was carried out across all the major databases. Two authors independently screened the titles and the abstracts, and those selected articles were assessed for quality using the GRADE approach. Comparisons were made of reported dysphagia and pneumonia frequencies, the relative risks of developing pneumonia were calculated. Data on duration of hospital stay and rates of mortality were also extracted.ResultsWe identified 86 citations, out of which only four articles were deemed eligible for critical analyses and data extraction. A high incidence (11.1% - 87.5%) of dysphagia was observed among stroke patients. Only two studies reported on incidence of pneumonia (22.8% - 32%); only one study stratified patients by both dysphagia and pneumonia. A relative risk of 5.82 (95% CI 4.6, 7.2) was found for pneumonia in patients with stroke and dysphagia. Data on length of hospital stay and rates of mortality secondary to aspiration pneumonia are also presented.ConclusionDespite high incidence of dysphagia and associated pneumonia the methodological quality of studies are low. There is a dire need for methodologically sound studies to accurate determine the incidence of dysphagia and its impact on stroke patients in India.

scholarly journals Clinical Significance of Oral Care and Oral Management on the Treatment and Prevention of Aspiration Pneumonia in the Elderly: Evidences and Pitfalls

2020 ◽  
pp. 1-5
Author(s):  
Shinji Teramoto ◽  
Shinji Teramoto
Keyword(s):  
Clinical Significance ◽  
Aspiration Pneumonia ◽  
Oral Care ◽  
The Elderly ◽  
Oral Bacteria ◽  
Healthcare Management ◽  
Elderly Persons ◽  
Swallowing Function ◽  
Treatment And Prevention ◽  
Swallowing Rehabilitation

Oral care and oral management are important for preventing aspiration pneumonia (ASP). The main pathology of ASP is microaspiration of oropharyngeal contents during night, swallowing rehabilitation must be necessary for the ASP treatment. However, swallowing rehabilitation cannot totally restore the normal swallowing function. Oral healthcare management should be initiated and continued in parallel with antibiotic treatment of ASP. Oral care helps to prevent aspiration pneumonia by reducing oral bacteria, while oral management helps by improving masticatory and rehabilitating functions. The efficacy of oral care for reducing the incidence of pneumonia has been clearly observed in untreated frail elderly patients, but not in well-cared elderly persons. It has been established that oral care is cyclically significant for the prevention of ASP in the elderly. However, oral problems are not the primary cause of ASP in the elderly. Although there is an amount of evidences of oral care for ASP prevention, there are some controversies of the clinical significance of oral care for ASP treatment.

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