Prandial aspiration and pneumonia in an elderly population followed over 3 years |
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Authors: | Michael J. Feinberg MD Janice Knebl DO Joann Tully MA |
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Affiliation: | (1) Department of Radiology and Medicine, Philadelphia, Pennsylvania, USA;(2) Department of Physical Medicare and Rehabilitation, Philadelphia, Pennsylvania, USA;(3) Philadelphia Geriatric Center, Philadelphia, Pennsylvania, USA;(4) North Shore University Hospital-Cornell University Medical College, 300 Community Drive, 11030 Manhasset, NY, USA |
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Abstract: | The purpose of our study was to prospectively determine pneumonia frequency and correlate it with prandial liquid aspiration and feeding status in frail elderly nursing home residents. Initially, 152 patients had video swallowing examinations (81 oropharyngeal dysphagia, 19 thoracic dysphagia, 52 without dysphagia). Those diagnosed with oropharyngeal impairment were subsequently managed with swallowing therapy or artificial feeding modalities. Patients were followed for 3 years (unless they expired earlier) and clinical courses were categorized according to the degree of prandial aspiration and feeding (PAF) status. Subjects with new lung infiltrates persisting for at least 5 days with appropriate clinical findings were diagnosed as having pneumonia and were classified according to the PAF status months in which these findings occurred. Fifty-six pneumonias were diagnosed during 4,280 months with the following frequencies: no aspiration months 0.6%; minor aspiration months 0.9%; major aspiration/oral feeding months 1,3%; major aspiration/artificial feeding months 4.4%, p<0.001. Our results indicate that there is not a simple and obvious relation between prandial liquid aspiration and pneumonia. Artificial feeding does not seem to be a satisfactory solution for preventing pneumonia in elderly prandial aspirators. |
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Keywords: | Prandial aspiration Aspiration pneumonia Deglutition Deglutition disorders Geriatrics |
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