title: Screening tests for predicting the prognosis of oral intake in elderly patients with acute pneumonia.
abstract: Many elderly patients with pneumonia have aspiration pneumonia. Therefore they must temporarily abstain from oral intake. However, it is difficult to predict whether or not they will be able to start oral intake. The reason is the standard method to evaluate deglutition about pneumonia patients has not been established. In this study we aimed to develop a simple and convenient method that predicts the prognosis of oral intake as nutrition among elderly patients with acute stage pneumonia. Participants were 77 inpatients fasting due to aspiration risk with acute pneumonia. (86.0 ± 7.7 years; range 68-105 years; men: n = 34, women: n = 43) during September 2011 and August 2013. Their consciousness levels were determined by Glasgow coma scale (GCS) and swallowing function and cough reflex were evaluated by repetitive saliva swallowing test (RSST), modified water swallow test, simple swallowing provocation test and cough test. Oral intake status at discharge was considered as the objective variable, and these tests were considered as explanatory variables. Then receiver operating characteristic (ROC) curve and the area under the curve (AUC) for each was done. From the ROC curve analysis, GCS ≥14 had the largest AUC (0.79) with a sensitivity and specificity of 0.71 and 0.80. That was followed by RSST ≥1, AUC (0.77) with a sensitivity and specificity of 0.81 and 0.67. These results suggest that GCS and RSST could be useful screening tests for prognostic prediction of oral intake capability in elderly patients with acute pneumonia.
authors.affiliation: Gerodontology and Oral Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8549, Japan.|Department of Oral and Maxillofacial Surgery, JCHO Tokyo Shinjuku Medical Center, Tokyo, Japan.
authors.forename: Shoko
authors.initials: S
authors.lastname: Oba
authors.affiliation: Gerodontology and Oral Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8549, Japan. haruka-t@rd5.so-net.ne.jp.
authors.forename: Haruka
authors.initials: H
authors.lastname: Tohara
authors.affiliation: Gerodontology and Oral Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8549, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Nakane
authors.affiliation: Clinical Research Center, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Tomita
authors.affiliation: Gerodontology and Oral Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8549, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Minakuchi
authors.affiliation: Gerodontology and Oral Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8549, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Uematsu
mesh_terms: D000208:Acute Disease; D000369:Aged, 80 and over; D004750:Enteral Nutrition; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D011015:Pneumonia, Aspiration / Q000150:complications* / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011379:Prognosis
keywords: Elderly; Oral intake; Pneumonia; Predict; Screening test