title: The Multidisciplinary Swallowing Team Approach Decreases Pneumonia Onset in Acute Stroke Patients.
abstract: Dysphagia occurs in acute stroke patients at high rates, and many of them develop aspiration pneumonia. Team approaches with the cooperation of various professionals have the power to improve the quality of medical care, utilizing the specialized knowledge and skills of each professional. In our hospital, a multidisciplinary participatory swallowing team was organized. The aim of this study was to clarify the influence of a team approach on dysphagia by comparing the rates of pneumonia in acute stroke patients prior to and post team organization. All consecutive acute stroke patients who were admitted to our hospital between April 2009 and March 2014 were registered. We analyzed the difference in the rate of pneumonia onset between the periods before team organization (prior period) and after team organization (post period). Univariate and multivariate analyses were performed using a Cox proportional hazards model to determine the predictors of pneumonia. We recruited 132 acute stroke patients from the prior period and 173 patients from the post period. Pneumonia onset was less frequent in the post period compared with the prior period (6.9% vs. 15.9%, respectively; p = 0.01). Based on a multivariate analysis using a Cox proportional hazards model, it was determined that a swallowing team approach was related to pneumonia onset independent from the National Institutes of Health Stroke Scale score on admission (adjusted hazard ratio 0.41, 95% confidence interval 0.19-0.84, p = 0.02). The multidisciplinary participatory swallowing team effectively decreased the pneumonia onset in acute stroke patients.
authors.affiliation: Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Aoki
authors.affiliation: Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
authors.forename: Naohisa
authors.identifier: 0000-0001-7486-9700
authors.initials: N
authors.lastname: Hosomi
authors.affiliation: Division of Nursing, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Hirayama
authors.affiliation: Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakamori
authors.affiliation: Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
authors.forename: Mineka
authors.initials: M
authors.lastname: Yoshikawa
authors.affiliation: Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Nezu
authors.affiliation: Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kubo
authors.affiliation: Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Nagano
authors.affiliation: Division of Nutrition Management, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Nagao
authors.affiliation: Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Yamane
authors.affiliation: Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Nishikawa
authors.affiliation: Division of Dental hygiene, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Megumi
authors.initials: M
authors.lastname: Takamoto
authors.affiliation: Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ueno
authors.affiliation: Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Ochi
authors.affiliation: Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Maruyama
authors.affiliation: Division of Nursing, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Yamamoto
authors.affiliation: Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
authors.forename: Masayasu
authors.initials: M
authors.lastname: Matsumoto
mesh_terms: D000328:Adult; D003679:Deglutition; D003680:Deglutition Disorders / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011015:Pneumonia, Aspiration / Q000150:complications* / Q000503:physiopathology / Q000517:prevention & control*; D011787:Quality of Health Care; D020521:Stroke / Q000150:complications*