Pilot study of 12-month outcomes of nursing home patients with aspiration on videofluoroscopy.
The 12-month clinical outcomes of nursing home patients who underwent videofluoroscopic swallowing evaluation was determined. A retrospective review of 40 patients in a teaching nursing home who had videofluoroscopic swallowing studies from 1987 through 1989 was performed. Clinical outcomes measured included feeding tube placement, rehospitalization within 1 year, prolonged nursing home stay (> 6 months), pneumonia, and pneumonia death. It was determined if outcomes were associated with the presence of aspiration on videofluoroscopy and subsequent feeding tube placement. In the 12-month follow-up period, 17 of 40 patients (43%) who underwent videofluoroscopic swallowing evaluation developed pneumonia and 18 of 40 (45%) died. Twenty-two patients demonstrated aspiration on videofluoroscopy. Increased rehospitalization was the only outcome measure that was associated with the presence of aspiration on videofluoroscopy (p < or = 0.05). Of 22 patients with aspiration, 15 had feeding tubes placed. This group had a higher rate of pneumonia (p < or = 0.05) and pneumonia death (p < or = 0.05) compared with the 7 patients with aspiration who did not receive feeding tubes. Patients with nasogastric tubes had a higher death rate (7/9) than patients with gastrostomy tubes (2/8; p < or = 0.05), but similar rates of rehospitalization and pneumonia. Nursing home patients who underwent video-fluoroscopic swallowing evaluation had poor clinical outcomes at 12 months, regardless of their test results.(ABSTRACT TRUNCATED AT 250 WORDS)
Croghan
J E
JE
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Burke
E M
EM
Caplan
S
S
Denman
S
S
D000368:Aged; D003680:Deglutition Disorders / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D004750:Enteral Nutrition; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D010865:Pilot Projects; D011015:Pneumonia, Aspiration / Q000209:etiology* / Q000517:prevention & control; D012189:Retrospective Studies; D014743:Videotape Recording