title: Effect of dysphagia rehabilitation on oral intake in elderly patients with aspiration pneumonia.
abstract: OBJECTIVE
  To clarify the effects of dysphagia rehabilitation on oral intake after aspiration pneumonia in older adults.
  
  
  METHODS
  The present retrospective observational study used data from the Japanese Diagnosis Procedure Combination inpatient database. We identified patients who were admitted to acute care hospitals with aspiration pneumonia. Patients were subdivided into those with and without dysphagia rehabilitation. The main outcome variable was total oral intake on discharge. We carried out multivariate logistic regression analysis to assess the effect of dysphagia rehabilitation on the outcome, with adjustment for patient backgrounds. We also carried out analyses based on pneumonia severity, and the timing and duration of dysphagia rehabilitation.
  
  
  RESULTS
  We identified 22,819 patients with dysphagia rehabilitation and 75,555 patients without dysphagia rehabilitation. The rates of total oral intake on discharge were 78.0 and 75.2%, respectively. The multivariate regression model showed that the dysphagia rehabilitation group had a significantly higher proportion of total oral intake on discharge (odds ratio 1.32; P < 0.001). Mild pneumonia patients had a higher odds ratio for total oral intake associated with dysphagia rehabilitation than patients with moderate and severe pneumonia (odds ratio 2.27; P < 0.001). Among patients who underwent a short period of dysphagia rehabilitation, those with early rehabilitation were more likely to achieve total oral intake at discharge than those with late rehabilitation.
  
  
  CONCLUSIONS
  The data suggest that dysphagia rehabilitation had a positive effect on total oral intake in elderly patients with aspiration pneumonia. Dysphagia rehabilitation showed greater benefit in patients with mild pneumonia than with more severe pneumonia.
authors.affiliation: Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan.|Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Momosaki
authors.affiliation: Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Yasunaga
authors.affiliation: Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Matsui
authors.affiliation: Department of Clinical Data Management and Research, Clinical Research Center, National Hospital Organization Headquarters, Tokyo, Japan.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Horiguchi
authors.affiliation: Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan.
authors.forename: Kiyohide
authors.initials: K
authors.lastname: Fushimi
authors.affiliation: Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Abo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000150:complications* / Q000534:rehabilitation*; D004435:Eating; D005260:Female; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D011015:Pneumonia, Aspiration / Q000150:complications*; D012189:Retrospective Studies
keywords: aspiration pneumonia; dysphagia; elderly; oral intake; rehabilitation