Prevalence and prognostic implications of dysphagia in elderly patients with pneumonia.
BACKGROUND
oropharyngeal dysphagia is a common condition among the elderly but not systematically explored.


OBJECTIVE
to assess the prevalence and the prognostic significance of oropharyngeal dysphagia among elderly patients with pneumonia.


METHODS
a prospective cohort study.


METHODS
an acute geriatric unit in a general hospital.


METHODS
a total of 134 elderly patients (>70 years) consecutively admitted with pneumonia.


METHODS
clinical bedside assessment of oropharyngeal dysphagia and aspiration with the water swallow test were performed. Demographic and clinical data, Barthel Index, Mini Nutritional Assessment, Charlson Comorbidity Index, Fine's Pneumonia Severity Index and mortality at 30 days and 1 year after admission were registered.


RESULTS
of the 134 patients, 53% were over 84 years and 55% presented clinical signs of oropharyngeal dysphagia; the mean Barthel score was 61 points indicating a frail population. Patients with dysphagia were older, showed lower functional status, higher prevalence of malnutrition and comorbidities and higher Fine's pneumonia severity scores. They had a higher mortality at 30 days (22.9% vs. 8.3%, P = 0.033) and at 1 year of follow-up (55.4% vs. 26.7%, P = 0.001).


CONCLUSIONS
oropharyngeal dysphagia is a highly prevalent clinical finding in elderly patients with pneumonia and is an indicator of disease severity in older patients with pneumonia.
Cabre
Mateu
M
Department of Internal Medicine, Hospital de Mataró, Barcelona, Spain. mcabre@csdm.cat
Serra-Prat
Mateu
M
Palomera
Elisabet
E
Almirall
Jordi
J
Pallares
Roman
R
Clavé
Pere
P
D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D003680:Deglutition Disorders / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D004185:Disability Evaluation; D016330:Frail Elderly; D015577:Geriatric Assessment; D006801:Humans; D011014:Pneumonia / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome