title: Meta-analysis of dysphagia and aspiration pneumonia in frail elders.
abstract: As part of a systematic literature review, a comprehensive literature search was carried out to identify risk factors for aspiration pneumonia in frail older people. A prominent risk factor found was dysphagia with evidence level 2a, according to the Oxford Centre for Evidence-based Medicine Levels of Evidence. Subsequently, a meta-analysis of 4 cohort, 1 case-cohort, and 1 case-control study on dysphagia as a risk factor of aspiration pneumonia in frail older people was performed. Using a random effects model, we found a positive correlation between dysphagia and aspiration pneumonia: OR = 9.84; 95%CI = 4.15 - 23.33 (test for statistical homogeneity: p < 0.001). Then, a subgroup meta-analysis was performed with 4 cohort studies, all including patients with a cerebrovascular disease. Once again, a positive correlation was found between dysphagia and aspiration pneumonia: OR = 12.93; 95%CI = 8.61 - 19.44. The test for statistical homogeneity revealed no statistically significant result (p = 0.15). It was concluded that dysphagia is a serious risk factor for aspiration pneumonia in frail older people, particularly in those suffering from a cerebrovascular disease.
authors.affiliation: BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, The Netherlands.
authors.forename: C D
authors.initials: CD
authors.lastname: van der Maarel-Wierink
authors.forename: J N O
authors.initials: JN
authors.lastname: Vanobbergen
authors.forename: E M
authors.initials: EM
authors.lastname: Bronkhorst
authors.forename: J M G A
authors.initials: JM
authors.lastname: Schols
authors.forename: C
authors.initials: C
authors.lastname: de Baat
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000150:complications*; D016330:Frail Elderly; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D011015:Pneumonia, Aspiration / Q000209:etiology*; D016016:Proportional Hazards Models; D012307:Risk Factors; D018709:Statistics, Nonparametric