Open AccessRisk Factors for Aspiration Pneumonia After Receiving Liquid‐Thickening Recommendations
Author(s) -
Masuda Hiroaki,
Ueha Rumi,
Sato Taku,
Goto Takao,
Koyama Misaki,
Yamauchi Akihito,
Kaneoka Asako,
Suzuki Sayaka,
Yamasoba Tatsuya
Publication year - 2022
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/01945998211049114
Subject(s) - thickening , aspiration pneumonia , pneumonia , medicine , foreign body aspiration , intensive care medicine , surgery , foreign bodies , engineering , pulp and paper industry
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.